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Prevalence, profile and predictors of malnutrition in children with congenital heart defects: a case–control observational study
  1. Christy A N Okoromah1,
  2. Ekanem N Ekure1,
  3. Foluso E A Lesi1,
  4. Wahab O Okunowo2,
  5. Bolande O Tijani3,
  6. Jonathan C Okeiyi4
  1. 1Department of Paediatrics, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
  2. 2Department of Biochemistry, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
  3. 3Nutrition Unit, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
  4. 4Department of Laboratory Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
  1. Correspondence to Christy A N Okoromah, Associate Professor and Consultant, Cardiology and Infectious Disease Unit, Department of Paediatrics, College of Medicine, University of Lagos, PMB 12003, Surulere, Idi-Araba, Lagos, Nigeria; faimer2004_christy{at}


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.

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  • Funding This study was supported by a research grant from the University of Lagos.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Research and Experimentation Ethics Committee of the University of Lagos and the College of Medicine of the University of Lagos.

  • Provenance and peer review Not commissioned; externally peer reviewed.