Short-Term Impact of Cardiac Intervention on the Nutritional Status of Malnourished Children with Congenital Heart Disease – A Report from a Developing African Country, Ethiopia

Abstract

Background and Objective

Malnutrition is a common problem in infants and children with congenital heart defect and has an impact on the disease outcome. This study aimed to assess the short-term impact of corrective cardiac intervention on growth recovery of malnourished children with congenital heart defects.

Methods

A retrospective cohort study was conducted over a year period (April 2021 to April 2022) by retrieving data from pediatric corrective cardiac interventions performed over a period of 5 years (2017–2021). We enrolled pediatric patients with congenital heart disease whose age is less than 18 years and have undergone corrective cardiac intervention. Those children identified to have malnutrition pre-operatively have been followed for 6 months postoperatively. Anthropometry measurements were used to measure the outcome, before intervention and every 3 months for a total of 6 months after correction.

Results

A total of 148 children from age 2 months to 18 years with a mean age of 5 years were included in the study. Most of the subjects had acyanotic CHD accounting for 93.2%. Magnitudes of underweight, wasting and stunting at pre intervention were 54%, 54.1% and 59.5% respectively, decreased to 40.7%, 39.2%, 49.2% and 29.3%, 25.9%, 34.8% at the 3^rd and 6^th month of the post intervention period respectively. Predictors of undernutrition at post intervention were type of CHD, age at correction, PAH, type of intervention and were summarized. Comparison of Z-scores for WFH and HFA on the 3^rd and 6^th month post intervention has shown significant improvement from baseline. Those subjects with PAH and older age at correction have a greater chance of being underweight and wasted.

Conclusion

Malnutrition is very common in children with CHD and is predicted by the presence of pulmonary hypertension and older age at correction. Corrective cardiac intervention significantly improved nutritional status during the follow-up over 6 months.

Keywords:

• congenital heart disease
• underweight
• wasting and stunting

Abbreviations

ASD, Atrial septal defect; AS, Aortic stenosis; AVSD, Atrioventricular septal defect; BAZ, Z score of Body mass index for age; CHD, Congenital heart defect; COA, Coarctation of aorta; EDHS, Ethiopia mini demographic and health survey; HFA, Height for age; PAH, Pulmonary arterial hypertension; PDA, Patent ductus arteriosus; PS, Pulmonary stenosis; SAM-LVOO, Sub aortic membrane with Left ventricular outflow obstruction; SPHMMC, Saint Paul’s hospital millennium medical college; SD, Standard deviation; SPSS, Statistical package for social science; TAVPR, Total anomalous pulmonary venous return; TGA, Transposition of great arteries; TOF, Tetralogy of Fallot; VSD, Ventricular septal defect; WFA, Weight for age; WFH, Weight for height; WHO, World health organization; ZHA, Z score of height for age; ZWA, Z score of weight for age; ZWH, Z score of weight for height.

Disclosure

The authors report no conflicts of interest in this work.