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Assessment of Nutritional Status of Children With Congenital Heart Disease: A Comparative Study
Awoere T Chinawa1, Josephat M Chinawa2, Chika Onyinyechi Duru3
1Department of Community Medicine, Enugu State University of Science and Technology, Enugu, Nigeria.
Insights
Children with congenital heart disease suffer significantly worse malnutrition, including wasting and stunting, compared to healthy children. This nutritional burden is particularly severe in children under five and those with cyanotic heart conditions.
Area of Science:
- Pediatrics
- Cardiology
- Nutritional Science
Background:
- Malnutrition is a significant health issue in tropical regions, disproportionately affecting children.
- Congenital heart disease (CHD) appears to exacerbate the burden of malnutrition in affected children.
Purpose of the Study:
- To assess the nutritional status of children diagnosed with congenital heart disease.
- To compare the nutritional status of children with CHD against a control group of healthy children.
Main Methods:
- A cross-sectional study design was employed.
- Congenital heart disease was confirmed using echocardiography.
- Nutritional status was evaluated using Anthro software to calculate Z-scores for weight-for-age (WAZ), height-for-age (HAZ), and weight-for-height (WHZ), along with Body Mass Index (BMI).
Main Results:
- Children with CHD exhibited significantly higher rates of wasting (38.5% vs. 6.25%) and stunting (37.8% vs. 7.0%) compared to controls.
- Malnutrition, particularly wasting, was more prevalent in children under five with CHD (42.9% vs. 6.2%).
- While overweight and obesity were observed in both groups, they were more pronounced in controls (4.2%) than in children with CHD (0.9%) within the under-five age group.
Conclusions:
- Children with congenital heart disease experience a greater degree of malnutrition than their healthy peers.
- The impact of malnutrition is more severe in younger children (under five) with CHD.
- Wasting is more common in cyanotic CHD, while overweight/obesity are more characteristic of malnutrition in non-CHD children.
Abstract:
Background: Malnutrition poses a great burden to children in the tropics. However, this seems to be accentuated in children with congenital heart disease. Objectives: The present study is therefore aimed at determining the nutritional status of children with congenital heart disease and to compare them with those without congenital heart disease. Methods: This is a cross-sectional study, where congenital heart disease was diagnosed by means of echocardiograph. Anthro software was used to calculate Z scores for weight for age (WAZ), height for age (HAZ), and weight for height (WHZ). Body mass index (BMI) was calculated by the formula BMI = Weight (Kg)/height (M2). Results: The body mass index-for-age z-score (BAZ) and height/length-for-age z-score (HAZ) were calculated for both subjects and controls to determine their nutritional status. It was observed that 38.5% (112/291) of the subjects were wasted (BAZ < -2SD) compared to 6.25% (16/256) of the controls and the difference was statistically significant (χ2 = 81.2, p < 0.001). Stunting (height/length-for-age z-score < -2SD) was also observed in a greater proportion of subjects than controls as 37.8% (107/291) of subjects were stunted compared with 7.0% (18/256) of the controls (χ2 = 69.9, p < 0.001). The under-five subjects had more cases of malnutrition than the controls of same age group as illustrated in Table 6. Whereas 42.9% (96/224) of the under-five subjects were wasted, only 6.2% (12/192) of the controls were wasted. On the other hand, 4.2% (8/192) of the under-five controls were obese compared to 0.9% (2/224) of the subjects of similar age group. Conclusion: Children with congenital heart disease present with varying degrees of malnutrition that is worse compared with children without congenital heart disease. The impact of malnutrition is worse among children under the age of five. Wasting is more prevalent in children with cyanotic heart disease compared with those with acyanotic congenital heart disease. Overweight and obesity were notable features of malnutrition in children with congenital heart disease, but this is worse in children without congenital heart disease.
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