Assessment of the physical growth and development in children with congenital heart diseases: A descriptive study
Abstract
Congenital heart diseases (CHD) are the anatomical abnormalities present at the birth resulting in abnormal cardiac function. Children with congenital heart diseases may grow or develop more slowly than other children. The present study was conducted with the objectives to assess the physical growth and development of children with CHD. A descriptive study was undertaken on 103 children with CHD attending/admitted in selected units of Advanced Cardiac Centre and Advanced Pediatric Centre PGIMER Chandigarh by Interview of parents and observation of children. Questionnaire contained four parts socio-demographic profile of Parents, Clinical profile of children, WHO growth charts and Vineland Social Maturity Scale. This study observed that most of children were toddlers (62.5%) and male child (62.5%).Most of children(91.3%) were diagnosed less than three years of age and most of children(41.3%) found suffering from ventricular septal defect (VSD). According to WHO 'z' scoring 31.7% of children were found severely stunted, 53.8% were found severely underweight. And 37.5% children were severely wasted and 55.8% children had below average intelligence. The present study concluded that some of children had growth retardation (i.e. severely stunted, severely underweight and severely wasted) and developmental delay (below average intelligence). It was also seen that there was no association of socio-demographic characteristics with their growth pattern.
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Introduction
Congenital heart diseases (CHD) are structural anomalies present at birth with incidence of 5 to 8 per 1000 live births.1Children with CHD are undernourished which affect their height and weight during their developmental period. Also they have delayed development milestones. Normal growth and development indicate good health in children and only growth is important parameter to assess their health status. 2 CHD often either have hypoxemia or pulmonary over circulation (shunting) concomitant danger for growth and development.
After birth, in children with congenital heart diseases weight is afflicted to a greater extent than height; however liner growth is also hindered in later ages.3 Studies conducted on children with CHD experience simultaneously decreases in growth trajectory across weight, length and head circumference this decrease suggested a role for altered regulation in children with CHD.4
Conclusion
The present study concluded that most of children with congenital heart diseases were below three years of age, male, from rural areas, living in lower socio-economic class ,had ventricular septal defect. Some of children had growth retardation (i.e. severely stunted, severely underweight and severely wasted) and developmental delay (below average intelligence).It was also seen that there was no association of socio-demographic characteristics with their growth pattern. It is recommended to be aware of the risks, prevention and diagnosis of congenital heart diseases so that early and necessary intervention could be incorporated to improve the outcome of disease.
Limitations
The study was conducted on small sample size due to boundaries of short period of data collection. The possible risk factors like pulmonary hypertension, presence of congestive heart failure and parental height were not assessed. The study was limited to children suffering with congenital heart defects between age group (Birth-12yr)
Future directions
The future studies can be conducted to large scale to explore more factors influencing the growth and development and also in post- operative children with congenital heart defects. The similar studies can be conducted to provide educational programs for identifications of risk factors and prevention of congenital birth defects.