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Published on: February 2, 2017
Longitudinal changes in BMI and growth with nutritional determinants in children with congenital heart disease: A
Adarsh Kumar Shukla1, Anjali Sharma1, Anagha Tulsi2
1Department of Genomics Research, Sri Sathya Sai Sanjeevani Research Centre, Palwal, Haryana, India.
Insights
Malnutrition is common in Indian children with congenital heart disease (CHD). Early corrective intervention significantly improves growth and nutritional status, especially in infants.
Area of Science:
- Pediatric Cardiology
- Nutritional Science
- Growth and Development
Background:
- Congenital heart diseases (CHDs) are linked to malnutrition and growth deficits in children.
- Understanding growth patterns and malnutrition risk factors is crucial for managing CHD patients.
Purpose of the Study:
- To assess growth patterns in children with CHD.
- To identify risk factors associated with malnutrition in this population.
Main Methods:
- Retrospective cohort study of 3838 children with CHD.
- Nutritional status assessed using WHO z-scores (BAZ, WAZ, HAZ).
- Logistic regression identified pre- and post-intervention risk factors for malnutrition.
Main Results:
- High baseline prevalence of underweight (53.6%), stunting (45.0%), and wasting (39.9%).
- Significant catch-up growth observed post-intervention, particularly linear growth (HAZ).
- Infants showed greatest improvement in BAZ and WAZ; ventricular septal defect subtype showed sustained improvement.
Conclusions:
- Malnutrition is highly prevalent in Indian children with CHD.
- Early corrective intervention leads to substantial nutritional improvement.
- Younger intervention age correlated with persistent early malnutrition.
Background:
Congenital heart diseases (CHDs) are closely associated with malnutrition and impaired growth. This study assessed growth patterns and identified risk factors for malnutrition in children with CHD.
Methods:
This retrospective cohort study included 3838 children with CHD who underwent corrective intervention. For long-term growth analysis, 966 children aged <12 years with a minimum 2 years follow-up were included. Nutritional status was evaluated using World Health Organization (WHO) z-scores standards. Wasting was determined from Body Mass Index-for-Age (BAZ), underweight from Weight-for-Age (WAZ), and stunting from Height-for-Age (HAZ) (z-score < -2). Growth trends were assessed across age groups and CHD subtypes. Logistic regression was performed to identify pre and post-interventional risk factors of malnutrition.
Results:
At baseline, 53.6% of children were underweight, 45.0% stunted, and 39.9% wasted. Significant post-intervention catch-up growth was observed, particularly for HAZ during follow-up (P < 0.001), indicating sustained linear growth recovery with the greatest improvement seen among infants (0-1 year) in BAZ and WAZ. Subtype analysis showed sustained improvement in ventricular septal defect (P < 0.001). Pre-intervention malnutrition was significantly associated with frequent fainting (syncope), paternal addiction, low socioeconomic status, and cyanosis (P < 0.001). Younger age at intervention was associated with higher odds of persistent early post-interventional malnutrition.
Conclusion:
Malnutrition is highly prevalent among Indian children with CHD but improves substantially following early corrective intervention.
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