Risk factors of malnutrition and growth faltering in children with congenital heart disease

Malnutrition in Congenital Heart Disease (CHD) patients is a known concern in the community and is common in developing countries with a prevalence of 86%. However, there are not many nutritional management programs for children with CHD in Indonesia. Risk factors for malnutrition and growth faltering in children with CHD in Indonesia have not been widely studied to this date. The objective of this study was to determine risk factors of malnutrition and growth faltering among children with CHD in our center. We enrolled 83 patients referred to the pediatric cardiology outpatient clinic Dr. Soetomo General Academic Hospital Surabaya. Collected data were analyzed using descriptive statistics, Chi-Square test, and binary regression.  Underweight, stunted, wasted, and growth faltering were seen in 54.2%, 43.4%, 53%, and 8.4%, respectively. There was a significant relationship between calorie intake and the presence of underweight, stunted, and wasted (p-value 0.05). Gestational age and mode of delivery were significantly associated with growth faltering (p 0.05). Binary regression showed that a calorie intake of 50-70% RDA-HA was associated with a 10.5 times higher risk of being stunted compared to children who received adequate nutrition of 70-100% RDA-HA (p = 0.004; OR 0.095; 95%CI 0.019-0.478). On the other hand, the mode of delivery shows a significant effect on growth faltering (p=0.031, OR 0.092, 95%CI 0.011-0.803). Based on the results, being underweight, stunted, and wasted are common findings in children with CHD. Calorie intake based on %RDA-HA is considered a significant risk factor for stunting among patients.