Somatic growth following congenital heart surgery in economically underprivileged children.
OBJECTIVE
To assess the impact of congenital heart surgery on anthropometric scores of growth in economically disadvantaged children.


METHODS
A cohort of 100 economically disadvantaged children was followed up after cardiac surgery for their nutritional recovery. Weight, height and body mass index for age were measured just before surgery and at a median period of 48.1 months (range 9-59.9 months) after surgery. Z scores of the age-adjusted variables were computed and McNemar OR was calculated for odds of improvement.


RESULTS
The mean weight for age of the cohort increased from 14.74±5.76 to 23.83±7.83 kg. In malnourished children (weight for age Z score ≤-2) the mean weight changed from -3.01 to -1.6 (p<0.05), the median improvement being 0.85. The paired OR for improvement was highest for weight (14.5; 95% CI 5 to 27), modest for BMI (1.57; 95% CI 0.56 to 6.34) and least for height (0.25; 95% CI 0.04 to 0.87). The proportion of malnourished children decreased from 61% to 27% after surgery. Subgroup analysis of the children with initial malnutrition showed significant improvement in weight for age Z scores (p=0.002) compared with non-malnourished children (paired OR 17.54; 95% CI 6.13 to 32.26), those with worse malnutrition faring better. Children with residual malnutrition tended to have extreme economic backwardness, surgery for cyanotic congenital heart disease or associated syndromes.


CONCLUSIONS
Congenital heart surgery resulted in a salutary improvement in the growth of children from economically underprivileged backgrounds. Residual malnutrition was likely to be associated with extreme economic backwardness, surgery for cyanotic congenital heart disease or coincidental syndromes.
Department of Paediatric Cardiology, Institute of Cardiovascular Diseases, The Madras Medical Mission, Mogappair, Chennai, Tamil Nadu, India.
Pankajkumar A
PA
Kasar
Department of Paediatric Cardiology, Institute of Cardiovascular Diseases, The Madras Medical Mission, Mogappair, Chennai, Tamil Nadu, India.
Raghavan Nair
RN
Suresh Kumar
Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala, India.
Vellappillil
V
Raman Kutty
Anthropometry; congenital heart disease; economic backwardness; epidemiology; malnutrition; paediatric cardiology; paediatric interventional cardiology; paediatric surgery; transposition of the great arteries