Prevalence, profile and predictors of malnutrition in children with congenital heart defects: a case-control observational study.
Date
2011-04
Authors
Okoromah, C.A.
Ekure, E.N.
Lesi, F.E.
Okunowo, W.O.
Tijani, B.O.
Okeiyi, J.C.
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ
Abstract
OBJECTIVE:
To investigate the prevalence, profile and predictors of severe malnutrition in children with congenital heart defects (CHDs).
DESIGN:
Case-control, observational study.
SETTING:
Tertiary teaching hospital in Lagos, Nigeria (March 2006 to March 2008).
PARTICIPANTS:
Children aged 3-192 months with uncorrected symptomatic CHD and healthy controls, frequency matched for age and sex.
MAIN OUTCOME MEASURES:
Prevalence of malnutrition based on WHO/National Center for Health Statistics/Centers for Disease Control and Prevention z score ≤-2; weight for age, weight for height/length and height for age; proportions of underweight, wasting and stunting in cases and controls, and in acyanotic and cyanotic CHD; and predictors of malnutrition using multivariate logistic analysis.
RESULTS:
90.4% of cases and 21.1% of controls had malnutrition (p=0.0001), and 61.2% and 2.6%, respectively, had severe malnutrition (p=0.0001). Wasting, stunting and underweight were identified in 41.1%, 28.8% and 20.5%, and 2.6%, 3.9% and 14.5% of cases and controls, respectively. Wasting was significantly higher (58.3%) in acyanotic CHD (p=0.0001), and stunting (68.0%) in cyanotic CHD (p=0.0001). Age at weaning was significantly lower in cases than controls (3.24±0.88 and 7.04±3.04 months, respectively; p=0.0001) and in acyanotic than cyanotic CHD (2.14±0.33 and 5.33±1.22 months, respectively; p=0.004). Predictors of malnutrition in CHD were anaemia, moderate to severe congestive heart failure (CHF), poor dietary intake of fat and prolonged unoperated disease.
CONCLUSION:
Severe malnutrition in association with anaemia and moderate to severe CHF is highly prevalent in CHD preoperatively in these children. Early weaning may be a marker of feeding difficulties in heart failure.
Description
Staff publications
Keywords
congenital heart defects , Malnutrition , Prevalence , Children , Nigeria , Congestive heart failure , Anaemia , Research Subject Categories::MEDICINE
Citation
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 Apr;96(4):354-60.