Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Rev Paul Pediatr. 2022 May 27;40:e2020512. doi: 10.1590/1984-0462/2022/40/2020512IN. eCollection 2022.
To describe weight and height evolution and to identify risk factors for insufficient anthropometric growth in children with congenital heart disease.
Historical cohort study including 131 children with congenital heart disease, followed up at a nutrition outpatient clinic. The anthropometric indices over time (initial score, after 12 and 24 months of follow-up) were analyzed using generalized estimating equations. The outcome was 'insufficient weight-height gain', defined as an increase of ≤0.5 in the z-score of weight-for-age (W/A), height-for-age (H/A) or body mass index-for-age (BMI/A) after 12 months of follow-up. Multiple logistic regression models were applied to identify risk and confounding factors.
The z-scores of W/A (p<0.001) and BMI/A (p<0.001) improved after 12 months, as well as the three indexes after 24 months (p<0.001). At the end of this period, 55.7% of the patients did not achieve an increase of >0.5 in the Z score of W/A; 77.1%, of H/A; and 45.8%, of BMI/A. A follow-up of less than five appointments was associated with insufficient gain in W/A (OR 7.78; 95%CI 3.04-19.88), H/A (OR 10.79; 95%CI 2.22-52.45) and BMI/A (OR 2.54; 95%CI 1.12-5.75). Not having undergone cardiac surgery and being aged ≥12 months were factors associated with insufficient W/A gain (OR 3.95; 95%CI 1.38-11.29/OR 3.60; 95%CI 1.33-9.72) and BMI/A (OR 2.81; 95%CI 1.08-7.28/OR 3.39; 95%CI 1.34-8.56). Low income was associated with insufficient H/A gain (OR 4.11; 95%CI 1.25-13.46).
Being aged less than or 12 months, the lowest number of appointments, absence of surgical treatment and low family income were risk factors for insufficient weight and height gain in children with congenital heart disease.
描述患有先天性心脏病儿童的体重和身高变化情况，并确定其生长不足的危险因素。
本研究为历史队列研究，纳入了 131 名在营养门诊接受随访的患有先天性心脏病的儿童。使用广义估计方程分析了随时间变化的体重指数（初始评分、随访 12 个月和 24 个月后）。将“体重-身高增长不足”定义为随访 12 个月后体重与年龄的 Z 评分（W/A）、身高与年龄的 Z 评分（H/A）或体重指数与年龄的 Z 评分（BMI/A）增加≤0.5。应用多因素逻辑回归模型来识别风险和混杂因素。
随访 12 个月后，W/A（p<0.001）和 BMI/A（p<0.001）的 Z 评分均有所改善，24 个月后三项指标均有改善（p<0.001）。在此期间，55.7%的患者 W/A 的 Z 评分增加未超过 0.5；77.1%的患者 H/A 的 Z 评分增加未超过 0.5；45.8%的患者 BMI/A 的 Z 评分增加未超过 0.5。随访次数少于 5 次与 W/A（OR 7.78；95%CI 3.04-19.88）、H/A（OR 10.79；95%CI 2.22-52.45）和 BMI/A（OR 2.54；95%CI 1.12-5.75）增长不足有关。未接受心脏手术和年龄≥12 个月与 W/A 增长不足（OR 3.95；95%CI 1.38-11.29/OR 3.60；95%CI 1.33-9.72）和 BMI/A 增长不足（OR 2.81；95%CI 1.08-7.28/OR 3.39；95%CI 1.34-8.56）有关。低收入与 H/A 增长不足（OR 4.11；95%CI 1.25-13.46）有关。
年龄小于或等于 12 个月、随访次数最少、未接受手术治疗和家庭收入低是患有先天性心脏病儿童体重和身高增长不足的危险因素。
