Factors Associated with Congenital Heart Disease in Severely Malnourished Children under Five and Their Outcomes at an Urban Hospital, Bangladesh (original) (raw)
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Factors Related to Malnutrition in Children Under Five Years with Congenital Heart Disease
Althea Medical Journal
Background: Congenital heart disease (CHD) is the most frequent type of heart disease that occurs in children. Children with CHD are more vulnerable to suffer impaired nutritional status related to morbidity and mortality. The nutritional status, however, may not be influenced only by CHD, but also by other factors.. The study was conducted to identify factors related to malnutrition in children with CHD Methods: This cross-sectional study involved 86 children with CHD recruited from Dr. Hasan Sadikin General Hospital Bandung from October to November 2015. Data collected in this study were obtained by conducting anthropometric measurements, interviewed the parents (obstetric history, patient's medical history and socioeonomic status) and from medical records (the type and time of CHD diagnosis, other diseases that accompanied the CHD). The collected data were presented by frequency distribution. Results: There were 46.5% patients who had nutritional disturbance. Malnutrition in males and patients with Tetralogy of Fallot were higher than other groups. Almost half patients with maternal history of passive smoking during pregnancy had nutritional disturbance. The most common disease found was diarrhea followed by lower respiratory infection. Percentage of normal children in low-income parents group was lower than the high-income group. Conclusions: Nearly half of patients have nutritional disturbance. Percentage of nutritional disturbance in male was higher compared to female. Active and passive smokers, Tetralogi Fallot, diarrhea, lower respiratory infection and lower income were factors contributed to malnutrition.
Malnutrition in Congenital Heart Disease
Journal of pharmaceutical research international, 2021
Congenital heart disease accounts for nearly twenty-eight percent of all the major congenital malformations, posing a significant global health problem. Prevalence of both cyanotic and acyanotic varies from 0.7 to 5.3/1000 patients in community-based study while hospital-based study statistics range between 3.9 and 26.4/1000 live births. The increase in birth rate and the requirement of surgical and non-surgical intervention makes it a high and challenging need task for emerging nations like India, where the framework isn't created at the root level. In this population a high prevalence of malnutrition is seen especially in infants. In the era of high survival rates, nutrition provides opportunity for development, growth optimization and a better standard of living. The morbidity & mortality associated malnutrition in infant with congenital heart disease can be reduced by early diagnosis / optimum treatment. Approximately half of the pediatric age population suffering from Congenital Heart Disease (CHD) are found to be malnourished where the most of the affected factor is found to be weight worse than height. The various contributory factors for malnutrition in CHD patients are cyanosis, heart defects, heart failure, pulmonary hypertension, anemia, and delayed corrective surgery. Early and Timely diagnosis is crucial as most congenital heart disorders can be corrected if apt intervention is provided, leading to better prognosis. Decreased caloric requirement , reduction in prevalence of respiratory tract infection, and better absorption will lead to early normalization of their malnourishment. The major studies done in the
The Egyptian Family Medicine Journal, 2019
Background: Malnutrition among children with Congenital Heart Disease (CHD) is considered a major public health problem causing significant impact on children morbidity and mortality. Objectives: The study aimed to assess the prevalence and epidemiological pattern of malnutrition among under-five Egyptian children with CHD. Methods: A cross sectional analytical study design included 300 children, having uncomplicated CHD. Hemoglobin level, serum iron and total iron binding capacity were recorded. Additionally, Anthropometric measurements were assessed and Z scores were calculated for weight for age (WAZ), weight for height (WHZ), and height for age (HAZ) have been calculated. Malnutrition was defined as weight, height, and weight/height Z score <-2. Results: Generally, prevalence of malnutrition among the studied sample of CHD children was 47%. Forty-four percent of the studied population were underweight, 29.7% were stunted, while wasting was only 6.7%. Malnutrition was significantly higher among those with low income compared to their expenditure (P = 0.038) and was significantly lower in those breastfed on regular intervals compared to those fed on demand (P = 0.002). Additionally, malnutrition was significantly higher in those receiving complementary feeding compared to those breastfed or bottle fed only (P value 0.03).Conclusion: Malnutrition is an obvious complicating problem in children with CHD, associated with existence of anemia, breastfeeding on demand and early-starting of complementary feeding.
Cardiology Research and Cardiovascular Medicine
Background: Malnutrition in children with congenital heart diseases has been associated with increased morbidity and mortality. The prevalence of severe malnutrition in this category of children ranged between 31.5% and 42.5% in developing countries and this figure may be rising with the declining global economic and security profile. Objectives: To determine the prevalence of under-nutrition among children with un-operated congenital heart defects and the relationship between types of heart defects and nutritional status of the patients. Methods: A cross sectional study of the nutritional status of children with unoperated congenital heart diseases attending the
BMC Pediatrics, 2021
Background: Children with congenital heart disease are at risk for poor growth and under-nutrition compared with healthy children. The aim of this study was to assess the nutritional status of children with congenital heart disease and associated factors in selected governmental hospitals and cardiac center Addis Ababa, Ethiopia. Method: Institutional based cross sectional study among 373 children aged under15 years was conducted from February to March; 2021G.c. Data was collected using structured questionnaire and chart review. Z-scores based on WHO reference ranges were used. Anthropometric z-scores based on WHO 2007 reference ranges were generated for each child. Weight-forage z-scores for children 0-10 years and height-forage and BMI-forage z-scores for all children. Binary logistic regression was used for associated factors. Result: A total of 373 children were participated in this study. The prevalence of wasting and stunting was 144(38.6%) and 134(35.9%) respectively. The prevalence of underweight and malnutrition in children under 10 years was 143(43.1%). Most of the children were diagnosed with VSD (36.7%). Children age group of 13 months-5 years were associated with wasting and underweight [AOR = 0.434, 95%CI: (0.231, 0.816)] and [AOR = 0.360, 95%CI: (0.183, 0.711)] respectively. Children diagnosed with PAH were 1.885 times more likely to be underweight [AOR = 1.885, 95%CI: (1.094, 3.246)]. When the hemoglobin level increases by every unit per g/dl the chance to be wasting and underweight decreases by 13.1 and 18.6%[AOR = 0.869, 95%CI: (0.792, 0.955)] and [AOR = 0.869, 95%CI: (0.792, 0.955)] respectively. The level of SPO2 is associated with stunting and underweight [AOR = 0.970, 95%CI: (0.943, 0.998)] and [AOR = 0.970, 95%CI: (0.943, 0.998)] respectively. Conclusion: The prevalence of malnutrition in children with CHD is pretty high. Decreased level of hemoglobin and SPO 2 was found to be associated factors for malnutrition in this case. There need to be a new strategy about including different health professional while care giving.
Myocardial performance index in severe acute malnutrition children aged 6 month to 5 years
International Journal of Contemporary Pediatrics, 2016
We evaluated myocardial performance index (MPI) which is a novel index that incorporates measures of both systolic and diastolic performance of heart and this index ABSTRACT Background: Severe Acute Malnutrition (SAM) is one of the most common health problems. Children suffering from SAM frequently exhibit cardiovascular abnormalities leading to morbidity and mortality. We evaluated myocardial performance index (MPI) to measure both systolic and diastolic functions of the heart. Methods: Hospital based prospective study in which we enrolled 100 children with SAM aged 6 months to 5 years admitted in malnutrition treatment centre (MTC), Bal Chikitaslya, Udaipur, Rajasthan, India. All the children underwent a detailed clinical and echocardiographic evaluation. The different echocardiographic variables along with MPI were calculated. Results: Out of 100 children majority of study population was in <-3SD, Z-score and <-4 SD, Z-score (63%), although extremes like <-5 SD to <-7SD, Z-score were also noted in 35% of children. In echocardigraphic variables ventricular function as mean ejection fraction was normal (70.69±9.57). The mean MPI was 0.41±0.11 with p-value of <0.001. Conclusions: MPI in SAM children was abnormally high inspite of normal ejection fraction. This can be used in children with SAM as early marker of ventricular dysfunction even before ejection fraction starts declining.
Cardiovascular Journal, 2017
Congenital heart disease is the most common cause of major congenital anomalies, representing a major global health problem. Twenty eight percent of all major congenital anomalies consist of heart defect. 1 Despite remarkable progress in clinical care for affected individuals, CHD remains the leading cause of infant mortality among birth defects. 2 For those that survive infancy, there is a high rate of comorbidities, both cardiac and extra cardiac, and expected lifespan is still diminished. 3 These issues have become increasingly important, as the number of adults with CHD now exceeds the number of children with CHD. 4 Between 25% to 30% of children with CHD have some form of additional congenital lesion, a comorbidity or structural extra cardiac anomaly (ECA) that may or may not be immediately apparent. However, comorbidity may have an important, even crucial, bearing on the course and outcome of the management of a child with a congenital heart lesion. 5 It is known that in recent years there has been an increase in the number of surgery on correction of congenital heart defects in children
Failure to thrive and Congenital Heart Disease among Infants of Hilly Regions
IAR Consortium, 2021
Background: Failure to thrive is slow physical development in a baby or child. It's caused by a baby or child not having enough nutrition .The aim of the study is to find association between failure to thrive (FTT) and Congenital Heart Disease(CHD) in newborns/infants. Material & Methods: This was a Cross-sectional observational study included children age between 0 to 1 year with suspected heart disease came to outdoor and indoor services of Department of Pediatrics IGMC , Shimla from July 2018 to June 2019. Results: In our study there were 102 participants in total. Out of them 57 participants were ≤1 month of age i.e. 57(55.90 % of total, 29(28.4%) between 2-6 months,16(15.7%) between 7-12 months. There were 55 males and 47 females. In the present study, Failure to thrive was present in 17 (16.7%) out of 102 study participants. Failure to thrive was seen in 16 patients among all 79 diagnosed patients with CHD. Odd ratio was 0.22 with CI (0.03-1.57), with P value of 0.14, which is not significant. The sensitivity ,specificity , positive predictive value(PPV) and negative predictive value(NPV) of failure to thrive in diagnosing CHD is 20.2 % , 95.6% , 94.1 % and 25.88% respectively Conclusion: It is important to determine whether failure to thrive results from congenital heart disease or factors in the environment, such as abuse or neglect.
2021
Background: Congenital heart disease (CHD) has already been recognized as one of the important cause of neonatal mortality and morbidity. The reported prevalence of CHD in live newborns tends to vary a lot due to various unrecognizable lesions at birth and lack of technical expertise. Aims & objectives: The ultimate aim of this study was to assess the birth incidence and pattern of congenital heart disease (CHD) using echocardiography in babies born in different government and private hospitals and also in different households. Results: Overall incidence of congenital heart disease in neonate in this study was 4.9 per 1000 live birth. Mean age of diagnosis was 22.5±4.6 days. Average weight of these neonates was 26.70 gm. 61.5 % neonates were female. 30.8% was preterm. Respiratory distress was the most common clinical presentation (76.9%). The commonest type of congenital heart disease was Ventricular septal defect (VSD) (61.5%). Maternal co-morbidity may have influence. 30.8% mother...