Risk factors for early occurrence of malnutrition in infants with severe congenital heart disease

Abstract

Abstract Purpose: To identify the risk factors of early occurrence of malnutrition in infants with severe congenital heart disease (CHD) during their first year of life. Methods and Results: Retrospective longitudinal multicentre study carried out from January 2014 to December 2020 in two tertiary care CHD centres. Four CHD hemodynamic groups were identified. Malnutrition was defined by a Waterlow score under 80% and/or the need for calorie-enriched formula. A total of 216 infants with a severe CHD, e.g., requiring cardiac surgery, cardiac catheterization, or hospitalization for heart failure during their first year of life were included in the study. Malnutrition was observed among 43% of the cohort, with the highest prevalence in infants with increased pulmonary blood flow (71%) compared to the others hemodynamic groups (p<0.001). In multivariate analysis, low birthweight (OR 0.62, 95% CI 0.44-0.89, p=0.009), CHD with increased pulmonary blood flow (OR 4.80, 95% CI 1.42-16.20, p=0.08), heart failure (OR 9.26, 95% CI 4.04-21.25, p<0.001), and the number of hospitalizations (OR 1.35, 95% CI 1.08l-1.69, p=0.009) during the first year of life were associated with malnutrition (AUC 0.85, 95% CI 0.79-0.90). Conclusion: In infants with a severe CHD, early occurrence of malnutrition during the first year of life affected a high proportion of subjects. CHD with increased pulmonary blood flow, low birthweight, heart failure, and repeated hospitalizations were risk factors for malnutrition. Further studies are required to identify optimal nutritional support in this population.