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[Nutritional assessment in infants with congenital heart disease: comparison of two anthropometric classifications]
C Le Roy1, G Larios1, D Springmüller1
1División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile.
Insights
Congenital heart disease (CHD) infants show high undernutrition rates. The Integrated Anthropometric Classification (IAC) identifies more undernutrition than the Health Ministry Criteria (HMC) in children with CHD.
Area of Science:
- Pediatrics
- Cardiology
- Nutritional Science
Background:
- Congenital heart disease (CHD) is associated with significant rates of undernutrition in infants.
- Accurate nutritional assessment in these children is challenging due to complex physiological factors.
Purpose of the Study:
- To evaluate and compare the nutritional status of infants with CHD using two distinct anthropometric classification systems.
- To determine the prevalence of undernutrition, risk of undernutrition, and obesity in this vulnerable population.
Main Methods:
- A non-concurrent cohort study involving 387 infants under 12 months undergoing cardiac surgery.
- Nutritional assessment utilized World Health Organization (WHO) standards, comparing the Health Ministry Criteria (HMC) with an Integrated Anthropometric Classification (IAC).
- Exclusion criteria included preterm infants, small for gestational age, genetic syndromes, or other conditions affecting nutritional status.
Main Results:
- 26.4% of infants presented with short stature.
- The Integrated Anthropometric Classification (IAC) identified a higher prevalence of undernutrition (38.5%) compared to the Health Ministry Criteria (HMC) (28.9%).
- Significant differences were observed in the classification of undernutrition, risk of undernutrition, and obesity between the two methods (p < 0.05).
Conclusions:
- Infants with congenital heart disease exhibit a high incidence of undernutrition and short stature.
- The Integrated Anthropometric Classification (IAC) offers a more precise diagnostic approach, avoiding overlapping diagnoses and detecting a greater proportion of undernourished children.
- While weight-for-age (P/E) can be a useful screening tool, it is insufficient for diagnosing chronic undernutrition in infants with CHD.
Introduction:
Children with congenital heart disease (CHD) present a high percentage of undern utrition and the interpretation of their nutritional assessment is difficult.
Objective:
To describe the nutritional status of infants with CHD using two anthropometric classifications and compare them.
Patients And Method:
Non-concurrent cohort study. We studied children under 12 months under going cardiac surgery. We excluded preterm infants, small for gestational age, carriers of genetic syndrome or other disease with nutritional compromise. Demographic data, type of CHD, weight and height were recorded. Nutritional assessment was performed using WHO standards per health ministry criteria (HMC) and per an Integrated Anthropometric Classification (IAC), which defines undernutrition if height-for-age Z-score (ZT/E)≤-2 and/or weight-for-height (ZP/T)≤-2, risk of un dernutrition as ZP/T between -1 to -1,9, normal as ZP/T between -0.9 to +0.9, overweight as ZP/T between +1 to +1.9 and obesity as ZP/T≥+2.
Results:
387 interventions were included, 219 (56.6%) were males, median age 3.1 months (IQR:0.4;6.4). A 26.4% presented short stature. Using HMC classification 55 subjects presented two diagnoses by overlap of ZP/E and ZP/T, although with IAC there was no overlap. Comparing HMC with IAC, a difference was found in undernutrition, 28.9% versus 38.5% (p = 0.001), risk of undernutrition 27.4% versus 16.3%(p = 0.01) and obesity 4.9% ver sus 3.3% (p = 0.03) respectively. Correlation was found between ZP/E and ZP/T, r = 0.6(p < 0.001) and between ZP/E and ZT/E, r = 0.6 (p < 0.001).
Conclusions:
Children with CHD have a high per centage of undernutrition and short stature. Using the same anthropometric measurements IAC did not present overlapping diagnoses and detected more undernutrition. P/E is useful as screening, but insufficient in chronic undernutrition.
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