Frequency and risk factors associated with malnutrition among children with congenital heart disease in a cardiology hospital.

Objectives. To assess the frequency and risk factors of malnutrition among children with congenital heart disease (CHID). Material and methods. Betwee n August 1997 and May 1998, a cross-sectional survey was conducted among 24 4 children, at the congenital heart disease ward of the Cardiology Hospital , National Medical Center "Siglo XXI", Mexican Institute of Social Security , in Mexico City. Study subjects were male and female children younger than 17 years, diagnosed with CHID and without any other congenital malformatio n. Weight/Age (W/A), Height/Age (H/A) and Weight/Height (W/H) were used to measure nutritional status; Z scores greater than -2 was the case definitio n of malnutrition. Risk factors investigated were age, sex, perinatal histo ry, dietary factors and nutritional supplementation, socioeconomic status, and family composition and functionality. Four CHID groups were studied: ac yanotic with and without pulmonary hypertension (APH, AWPH) and, cyanotic w ith and without pulmonary hypertension (CPH, CWPH). Statistical analysis co nsisted of the chi-squared, Mann Whitney's U, and Kruskal-Wallis tests. Con founding variables were controlled for with a logistic regression model; od ds ratios (OR) and 95% confidence intervals (95%CI) were calculated. Result s. APH was the most frequent CHID (62.7%), followed by CWPH (15.6%), AWPH ( 11.5%), and CPH (10.2%). Malnutrition was identified in 40.9% children with the W/A index, in 24.6% with the H/A index; and in 31.1% with the W/H inde x. Infants and the CPH group had the worst nutritional status Risk factors associated with malnutrition were: having a cyanotic CHID (OR 2.54; 95%CI, 0.98-6.58), lack of nutritional supplementation (OR 2.38; 95%CI, 1.06-5.34) , and a greater number of family members (OR, 1.42; 95%CI, 0.99-2.05). Olde r children were more likely to be well-nourished (OR 0.92; 95%CI, 0.89-0.96 ). Conclusions. Malnutrition is frequent among children with CHD; it is mor e common in younger children and in those with cyanotic CHID. Educational p rograms directed to the families of these children are needed to prevent an d decrease the frequency of malnutrition. The English version of this paper is available at: http://www.insp.mx/salud/index.html.