Malnutrition in children with congenital heart disease (CHD): Determinants and short-term impact of corrective intervention
Publication Type:Journal Article
Source:Indian Pediatrics, Volume 45, Number 7, p.541-546 (2008)
Keywords:anthropometry, article, Congenital, congenital heart disease, congestive heart failure, controlled study, demography, educational status, fat intake, female, follow up, Follow-Up Studies, genetic disorder, gestational age, Heart Defects, human, Humans, India, infant, low birth weight, major clinical study, male, malnutrition, multivariate logistic regression analysis, newborn, Nutritional Status, Premature, preschool child, prevalence, Prospective Studies, Risk Factors, Time Factors
Objective: To identify determinants of malnutrition in children with congenital heart disease (CHD) and examine the short-term effects of corrective intervention. Methods: Patients with CHD admitted for corrective intervention were evaluated for nutritional status before and 3 months after surgery. Detailed anthropometry was performed and z-scores calculated. Malnutrition was defined as weight, height and weight/height z-score ≤ -2. Determinants of malnutrition were entered into a multivariate logistic regression analysis model. Results: 476 consecutive patients undergoing corrective intervention were included. There were 16 deaths (3.4%; 13 in-hospital, 3 follow-up). The 3-month follow-up data of 358 (77.8%) of remaining 460 patients were analyzed. Predictors of malnutrition at presentation are as summarized: weight z-score ≤ -2 (59%): congestive heart failure (CHF), age at correction, lower birth weight and fat intake, previous hospitalizations , ≥ 2 children; height z-score ≤ -2 (26.3%): small for gestation, lower maternal height and fat intake, genetic syndromes; and weight/height z-score ≤ -2 (55.9%): CHF, age at correction, lower birth weight and maternal weight, previous hospitalizations, religion (Hindu) and level of education of father. Comparison of z-scores on 3-month follow-up showed a significant improvement from baseline, irrespective of the cardiac diagnosis. Conclusions: Malnutrition is common in children with CHD. Corrective intervention results in significant improvement in nutritional status on short-term follow-up.
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