Longitudinal changes in BMI and growth with nutritional determinants in children with congenital heart disease: A retrospective cohort study.

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.