Peer-reviewed article
The Prevalence of Malnutrition in Children With Congenital Heart Disease: A Meta-Analysis.
Jihye Lee, Harleah G Buck, Pamela Mulder, Seok-Yeong Hong, Teresa A Marshall et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This meta-analysis of 37 studies found that malnutrition is common in children with congenital heart disease (CHD), affecting about one-third of children across different measures. Underweight was most common in infants (38%), while stunting and wasting were highest in toddlers and preschoolers. Children with pulmonary arterial hypertension had significantly higher risk of all forms of malnutrition, and those with cyanosis had higher stunting risk.
Key points
- Pooled prevalence of underweight was 34.3%, stunting 30.8%, and wasting 25.5% among children with CHD
- Underweight most common in infants (38.3%); stunting and wasting highest in toddler-to-preschool age group (32.5% and 27.8%)
- Children with pulmonary arterial hypertension had 4.24 times higher odds of being underweight, 3.11 times higher odds of stunting, and 1.32 times higher odds of wasting
- Children with cyanosis had 1.38 times higher odds of stunting, though not statistically significant
- Malnutrition risk varies by age group and specific CHD disease characteristics
Limitations
This meta-analysis describes the prevalence and associations of malnutrition in children with CHD but does not evaluate interventions to address it. The studies included may have used different definitions and measurement methods for malnutrition, which could affect comparability.
Abstract
BACKGROUND: Although numerous studies have documented the high prevalence of malnutrition in children with congenital heart disease (CHD), variability in findings has made it difficult to estimate true risk. This meta-analysis aimed to estimate the pooled prevalence of malnutrition by age group and examine its association with CHD-specific disease characteristics. METHODS: Following PRISMA guidelines, a meta-analysis was conducted to determine the pooled prevalence of underweight, stunting, and wasting, stratified by age group. The odds of malnutrition were also analyzed based on CHD disease characteristics. RESULTS: Thirty-seven studies were included. The pooled prevalence of underweight was 34.3% (N = 83,321), stunting 30.8% (N = 84,033), and wasting 25.5% (N = 72,283). Prevalence differed by age and malnutrition subtype: underweight was most common in infants (38.3%), while stunting (32.5%) and wasting (27.8%) were highest in the toddler-to-preschool age group. Children with pulmonary arterial hypertension (PAH) had significantly higher odds of being underweight (Odds Ratio, OR = 4.24), stunted (OR = 3.11), and wasted (OR = 1.32). Children with cyanosis also had elevated odds of stunting (OR = 1.38), though not statistically significant. CONCLUSION: Malnutrition is common among children with CHD and varies by malnutrition type, age group, and disease characteristics. The elevated risk in children with PAH and cyanosis suggests the importance of disease-specific monitoring and intervention strategies. Tailored approaches based on patient age and clinical profile may help improve growth outcomes in this vulnerable population.