ESPE Abstracts

Background: Children with congenital heart disease (CHD) are predisposed to growth failure, due to the decreased intake of nutrients and also due to the increased energy requirements. Growth failure represents a frequent cause of increase of both morbidity and mortality in children with CHD.

Objective and hypotheses: Assessment of physical development in children with CHD and identification of significant factors that influence z scores.

Method: We monitored the severity of the growth and development disorders in children with various types of CHD. We followed up the prevalence of growth failure in 117 children with CHD, aged 1 month and 10 years. In all cases we evaluated the demographic factors, clinical factors, socio-economic level, and the nutrition history. We performed anthropometry and then, calculated the z score for weight, height, and weight/height, using WHO-2007 reference values.

Results: From a total of 117 children with congenital heart disease (72 boys and 45 girls), 39 children (33.3%) presented a normal z score, 78 children (66.6%) presented malnutrition: 20 children (25.6%) mild malnutrition (−2<z score <−1), 24 children (30.8%) moderate malnutrition (−3<z score <−2), and 34 children (43.6%) severe malnutrition (z score <−3). Weight-for-age z-score was ≤−2 for 75 children (44.38%), weight-for-height was ≤−2 for 48 children (28.4%), and height-for-age was ≤−2 for 72 children (42.6%). Comparing z scores we have identified a significant difference (P<0.01) between averages of height-for-age z-scores and statistically highly significant (P<0.001) for weight-for-age z-scores between children born prematurely and eutrophic children. The presence of heart failure (HF) influenced negatively the physical development in children with CHD, P=0.0001 in weight-for-age z-score and P=0.015 in height-for-age z-score. Inappropriate food selection has been negatively correlated with physical development (P<0.05, 95% CI).

Conclusion: Children with CHD often present growth failure, therefore, is very important to monitor the nutritional status in these children, in order to prevent occurring and enhanced of deficits.