Malnutrition and Growth Failure in Cyanotic and Acyanotic Congenital Heart Diseases   with and Without Pulmonary Hypertension

Shahnawaz Sathio; Basharat Hussain; Fazal ur Rehman; Mehtab Hussain; Mujeeb ur Rehman; Saad Ullah Siddiqui

doi:10.51253/pafmj.v74i5.7709

Authors

Shahnawaz Sathio Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases, Hyderabad Pakistan
Basharat Hussain Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases, Karachi Pakistan
Fazal ur Rehman Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases, Karachi Pakistan
Mehtab Hussain Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases, Karachi Pakistan
Mujeeb ur Rehman Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases, Karachi Pakistan
Saad Ullah Siddiqui Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases, Karachi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i5.7709

Keywords:

Acyanotic, Congenital Heart Disease, Cyanotic, Pulmonary Hypertension

Abstract

Objective: To determine the status of malnutrition and growth failure in cyanotic and acyanotic congenital heart diseases with and without pulmonary hypertension.

Study Design: Cross sectional study.

Place and Duration of Study: Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases, Tando Muhammad Khan, Pakistan, from Jan 2020 to Oct 2021.

Methodology: A total of 250 children, with echocardiography confirmed congenital heart disease, of both genders and aged below 5 years were included. All cases were divided into 4 groups, these being, acyanotic congenital heart disease with PH, acyanotic congenital heart disease without pulmonary hypertension, cyanotic congenital heart disease with pulmonary hypertension and cyanotic Congenital heart disease without pulmonary hypertension. Gender, age, body weight, height, area of residence and malnutrition status were determined in all cases and compared in between study groups.

Results: There were 41(16.4%) patients with acyanotic PH, 115(46.0%) acyanotic without PH, 34(13.6%) cyanotic with pulmonary hypertension and 60(24.0%) cyanotic without pulmonary hypertension among a total of 250 cases. Significant differences were noted in terms of age, weight, and height among different study groups (p<0.001). Nutritional status as normal was noted in 51(20.4%) cases, mild malnutrition in 50(20.0%), moderate malnutrition in 65(26.0%) and 84(33.6%) with severe malnutrition. Children having cyanotic congenital heart disease and pulmonary hypertension were also found to have failure to thrive (p=0.009).

Conclusion: Malnutrition and growth failure were found to be very prevalent among children with CHDs under the age of 5 years. Malnutrition was significantly more pronounced among children having cyanotic CHDs with PH.

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References

Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 2008; 371(9608): 243-260. https://doi.org/10.1016/S0140-6736(07)61690-0

Mena MB, Dedefo MG, Billoro BB. Treatment outcome of severe acute malnutrition and its determinants among Pediatric patients in West Ethiopia. Int J Pediatr 2018; 2018: 8686501.

https://doi.org/10.1155/2018/8686501

India State-Level Disease Burden Initiative Malnutrition Collaborators. The burden of child and maternal malnutrition and trends in its indicators in the states of India: the Global Burden of Disease Study 1990-2017. Lancet Child Adolesc Health 2019; 3(12): 855-870.

https://doi.org/10.1016/S2352-4642(19)30273-1

Chinawa AT, Chinawa JM, Duru CO, Chukwu BF, Obumneme-Anyim I. Assessment of nutritional status of children with Congenital Heart Disease: A comparative study. Front Nutr 2021; 8: 644030. https://doi.org/10.3389/fnut.2021.644030

Okoromah CA, Ekure EN, Lesi FE, Okunowo WO, Tijani BO, Okeiyi JC, et al. Prevalence, profile, and predictors of malnutrition in children with congenital heart defects: a case-control observational study. Arch Dis Child 2011; 96(4): 354-360.

https://doi.org/10.1136/adc.2009.176644

Thompson-Chagoyan OC, Reyes-Tsubaki N, Rabiela-Barrios OL, Buendia-Hernandez A, Miranda-Chavez I, Carrasco-Quintero R. The nutritional status of the child with congenital cardiopathy. Arch Inst Cardiol Mex 1998; 68: 119-123.

Okoromah CA, Ekure EN, Lesi FE, Okunowo WO, Tijani BO, Okeiyi JC. Prevalence, profile, and predictors of malnutrition in children with congenital heart defects: a case-control observational study. Arch Dis Child 2011; 96(4): 354-360.

https://doi.org/10.1136/adc.2009.176644

Arodiwe I, Chinawa J, Ujunwa F, Adiele D, Ukoha M, Obidike E. Nutritional status of congenital heart disease (CHD) patients: Burden and determinant of malnutrition at university of Nigeria teaching hospital Ituku - Ozalla, Enugu. Pak J Med Sci 2015; 31(5): 1140-1145. https://doi.org/10.12669/pjms.315.6837

Varan B, Tokel K, Yilmaz G. Malnutrition, and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary hypertension. Arch Dis Child 1999; 81(1): 49-52.

https://doi.org/10.1136/adc.81.1.49

Hassan BA, Albanna EA, Morsy SM, Siam AG, Al Shafie MM, Elsaadany HF, et al. Nutritional status in children with un-operated congenital heart disease: an Egyptian center experience. Front Pediatr 2015; 3: 53.

https://doi.org/10.3389/fped.2015.00053

Mehrizi A, Drash A. Growth disturbance in congenital heart disease. J Pediatr. 1962; 61: 418-429.

https://doi.org/10.1016/S0022-3476(62)80373-4

Tokel K, Azak E, Ayabakan C, Varan B, Aslamaci SA, Mercan S, et al. Somatic growth after corrective surgery for congenital heart disease. Turk J Pediatr 2010; 52(1): 58-67.

https://doi.org/10.1542/peds.2009-0141

Tabib A, Aryafar M, Ghadrdoost B. Prevalence of malnutrition in children with congenital heart disease. J Compr Ped 2019; 10(4): e84274. https://doi.org/10.5812/compreped.84274

Arshad MS, Anwar-ul-Haq HM, Adnan M, Zulqarnain A. Frequency, and pattern of Paediatric Heart Diseases: Five years’ experience at The Children’s Hospital, Multan. Pak J Med Sci 2020; 36(6): 1308-1312. https://doi.org/10.12669/pjms.36.6.2312

Villasis-Keever MA, Aquiles Pineda-Cruz R, Halley-Castillo E, Alva-Espinosa C. Frequency, and risk factors associated with malnutrition in children with congenital cardiopathy. Salud Publica Mex 2001; 43(4): 313-323.

Costello CL, Gellatly M, Daniel J, Justo RN, Weir K. Growth Restriction in infants and young children with congenital heart disease. Congenit Heart Dis. 2015; 10(5): 447-456.

https://doi.org/10.1111/chd.12231

Toole BJ, Toole LE, Kyle UG, Cabrera AG, Orellana RA, Coss-Bu JA. Perioperative nutritional support and malnutrition in infants and children with congenital heart disease. Congenit Heart Dis 2014; 9(1): 15-25.

https://doi.org/10.1111/chd.12064

Assefa B, Tadele H. Severe acute malnutrition among unoperated Ethiopian children with congenital heart disease: A wake-up call to reverse the situation, A retrospective cross-sectional study. Ethiop J Health Sci 2020; 30(5): 707-714.

https://doi.org/10.4314/ejhs.v30i5.9