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

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Abstract

To identify the risk factors of early occurrence of malnutrition in infants with severe congenital heart disease (CHD) during their first year of life. Retrospective longitudinal multicenter study carried out from January 2014 to December 2020 in two tertiary care CHD centers. Four CHD hemodynamic groups were identified. Malnutrition was defined by a Waterlow score under 80% and/or underweight under -2 standard deviations. 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 other 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 1.08 l–1.69, p = 0.009) during the first year of life were associated with malnutrition (AUC 0.85, 95% CI 0.79–0.90).

  Conclusions: 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.

What is Known:

• Malnutrition is a known morbidity and mortality factor in children with severe congenital heart disease.

What is New:

• Early occurrence of malnutrition during the first year of life in infant severe congenital heart disease (CHD) was high (43%).

• CHD with increased pulmonary blood flow, low birthweight, heart failure, and repeated hospitalizations during the first year of life were risk factors for malnutrition.

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Author notes

  1. Laura Kollen and Arthur Gavotto contributed equally to this work.

Authors and Affiliations

  1. Department of Pediatric Gastroenterology, Montpellier University Hospital, Montpellier, France

    Margot Mignot & Laura Kollen

  2. Epidemiology and Clinical Research Department, Montpellier University Hospital, Montpellier, France

    Helena Huguet & Marie-Christine Picot

  3. Epidemiology and Biostatistics, Clinical Investigation Centre, INSERM, University of Montpellier, Montpellier, France

    Helena Huguet & Marie-Christine Picot

  4. Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital, 371 Avenue du Doyen Giraud, Montpellier, 34295, France

    Gilles Cambonie & Arthur Gavotto

  5. Pathogenesis and Control of Chronic Infection, INSERM, UMR 1058, University of Montpellier, Montpellier, France

    Gilles Cambonie

  6. Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France

    Sophie Guillaumont & Marie Vincenti

  7. Pediatric Cardiology and Rehabilitation Unit, St-Pierre Institute, Palavas-Les-Flots, France

    Sophie Guillaumont

  8. Pediatric and Congenital Cardiology Department, Timone Children Hospital, Aix-Marseille University, Marseille, France

    Julie Blanc & Caroline Ovaert

  9. Pediatric Cardiology Unit, Children Hospital, Toulouse Hospital, Toulouse, France

    Clement Karsenty

  10. Institut Des Maladies Métaboliques et Cardiovasculaires, Université de Toulouse, INSERM U1048, I2MC, Toulouse, France

    Clement Karsenty

  11. Pediatric and Congenital Cardiology Department, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux, France

    Pascal Amedro

  12. IHU Liryc, Electrophysiology and Heart Modelling Institute, INSERM 1045, Bordeaux University Foundation, Pessac, France

    Pascal Amedro

  13. PhyMedExp, CNRS, INSERM, University of Montpellier, Montpellier, France

    Arthur Gavotto

Authors
  1. Margot Mignot
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  2. Helena Huguet
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Dr. Mignot, Ms. Huguet, Pr. Cambonie, Dr. Kollen, and Dr. Gavotto. The first draft of the manuscript was written by Dr. Mignot, Pr Cambonie, Dr. Kollen, and Dr. Gavotto and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Arthur Gavotto.

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Competing interests

The authors declare no competing interests.

Ethics approval

The study was conducted in compliance with the Good Clinical Practices and Declaration of Helsinki principles. The Institutional Review Board of Montpellier University Hospital (IRB-MPT_2020_02_202000362) gave its approval and all parents or legal guardians gave their informed consent.

Additional information

Communicated by Daniele De Luca.

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Mignot, M., Huguet, H., Cambonie, G. et al. Risk factors for early occurrence of malnutrition in infants with severe congenital heart disease. Eur J Pediatr 182, 1261–1269 (2023). https://doi.org/10.1007/s00431-023-04812-9

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  • DOI: https://doi.org/10.1007/s00431-023-04812-9

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