Malnutrition and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary hypertension
Birgül Varan, Kür
ad Tokel, Gonca Yilmaz
Department of
Pediatrics, Bakent University School of Medicine, Bahçelievler
06490 Ankara, Turkey
Correspondence to: Dr Varan.
Accepted 8
December 1998
AIM
To investigate the
effect of several types of congenital heart disease (CHD) on nutrition
and growth.
PATIENTS AND
METHODSThe prevalence of malnutrition and growth
failure was investigated in 89 patients with CHD aged 1
45 months.
They were grouped according to cardiac diagnosis: group aP (n = 26),
acyanotic patients with pulmonary hypertension; group ap (n = 5),
acyanotic patients without pulmonary hypertension; group cp (n = 42),
cyanotic patients without pulmonary hypertension; and group cP
(n = 16), cyanotic patients with pulmonary hypertension. Information
on socioeconomic level, parental education status, birth weight and
nutrition history, number of siblings, and the timing, quality, and
quantity of nutrients ingested during weaning period and at the time of
the examination were obtained through interviews with parents.
RESULTSThere was no
significant difference between groups in terms of parental education
status, socioeconomic level, duration of breast feeding, and number of
siblings (p > 0.05). Group cP patients ingested fewer nutrients for
their age compared to other groups. 37 of the 89 patients were below
the 5th centile for both weight and length, and 58 of 89 patients were
below the 5th centile for weight. Mild or borderline malnutrition was
more common in group aP patients. Most group cp patients were in normal
nutritional state, and stunting was more common than wasting. Both
moderate to severe malnutrition and failure to thrive were more common in group cP patients.
CONCLUSIONPatients
with CHD are prone to malnutrition and growth failure. Pulmonary
hypertension appears to be the most important factor, and cyanotic
patients with pulmonary hypertension are the ones most severely
affected. This study shows the additive effects of hypoxia and
pulmonary hypertension on nutrition and growth of children with CHD.
Keywords: congenital heart disease; pulmonary hypertension; cyanosis; malnutrition; growth failure
© 1999 by Archives of Disease in Childhood
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