Longitudinal changes in BMI and growth with nutritional determinants in children with congenital heart disease: A retrospective cohort study

BACKGROUND: Congenital heart diseases (CHDs) are closely associated with malnutrition and impaired growth. This study assessed growth patterns and identified risk factors for malnutrition in children with CHD. METHODS: This retrospective cohort study included 3838 children with CHD who underwent corrective intervention. For long-term growth analysis, 966 children aged <12 years with a minimum 2 years follow-up were included. Nutritional status was evaluated using World Health Organization (WHO) z-scores standards. Wasting was determined from Body Mass Index-for-Age (BAZ), underweight from Weight-for-Age (WAZ), and stunting from Height-for-Age (HAZ) (z-score < -2). Growth trends were assessed across age groups and CHD subtypes. Logistic regression was performed to identify pre and post-interventional risk factors of malnutrition. RESULTS: At baseline, 53.6% of children were underweight, 45.0% stunted, and 39.9% wasted. Significant post-intervention catch-up growth was observed, particularly for HAZ during follow-up (P < 0.001), indicating sustained linear growth recovery with the greatest improvement seen among infants (0-1 year) in BAZ and WAZ. Subtype analysis showed sustained improvement in ventricular septal defect (P < 0.001). Pre-intervention malnutrition was significantly associated with frequent fainting (syncope), paternal addiction, low socioeconomic status, and cyanosis (P < 0.001). Younger age at intervention was associated with higher odds of persistent early post-interventional malnutrition. CONCLUSION: Malnutrition is highly prevalent among Indian children with CHD but improves substantially following early corrective intervention.