Impact of underweight, overweight and obesity on health-related quality of life in children with congenital heart defects of the right ventricular outflow tract

Background: Traditional cardiovascular risk factors put patients with congenital heart disease (CHD) at increased risk for cardiovascular morbidity and mortality. It was the aim of this study to evaluate whether body mass index (BMI) is associated with health-related quality of life (HRQoL) in patients with right ventricular outflow obstructive (RVOTO) lesions. Methods: Patients and parents of children with RVOTO type CHD were asked to fill out the PedsQL 4.0 questionnaire and provide weight and length. Patients were categorized into low, normal, and high BMI percentiles. Other demographic data was obtained from the Swedish national registry for congenital heart disease (SWEDCON). Statistical analyses included non-parametric Mann-Whitney U test, Fisher exact and Chi-square tests. Results: 85 patients were included. There was a significant difference in age and gender between the groups. Twelve were overweight or obese, 57 had a normal BMI and 16 were underweight. Comparing overweight/obese children to those with normal BMI, physical and social functioning were impaired, while emotional and school function were comparable between the groups. This applied to both child and parental assessment. When comparing underweight to normal weight children, school functioning assessed by the parent was the only domain significantly different from controls. Conclusion: Children with RVOTO type CHD and overweight/obesity have lower HRQoL, particularly in physical and social functioning, while underweight children may have impaired school functioning. We suggest that preventive measures aimed at maintaining a normal weight should be taken early in life to reduce long-term cardiovascular risk in the CHD population.