The Prevalence of Malnutrition in Children With Congenital Heart Disease: A Meta-Analysis.

BACKGROUND

Although numerous studies have documented the high prevalence of malnutrition in children with congenital heart disease (CHD), variability in findings has made it difficult to estimate true risk. This meta-analysis aimed to estimate the pooled prevalence of malnutrition by age group and examine its association with CHD-specific disease characteristics.

METHODS

Following PRISMA guidelines, a meta-analysis was conducted to determine the pooled prevalence of underweight, stunting, and wasting, stratified by age group. The odds of malnutrition were also analyzed based on CHD disease characteristics.

RESULTS

Thirty-seven studies were included. The pooled prevalence of underweight was 34.3% (N = 83,321), stunting 30.8% (N = 84,033), and wasting 25.5% (N = 72,283). Prevalence differed by age and malnutrition subtype: underweight was most common in infants (38.3%), while stunting (32.5%) and wasting (27.8%) were highest in the toddler-to-preschool age group. Children with pulmonary arterial hypertension (PAH) had significantly higher odds of being underweight (Odds Ratio, OR = 4.24), stunted (OR = 3.11), and wasted (OR = 1.32). Children with cyanosis also had elevated odds of stunting (OR = 1.38), though not statistically significant.

CONCLUSION

Malnutrition is common among children with CHD and varies by malnutrition type, age group, and disease characteristics. The elevated risk in children with PAH and cyanosis suggests the importance of disease-specific monitoring and intervention strategies. Tailored approaches based on patient age and clinical profile may help improve growth outcomes in this vulnerable population.