The effect of cyanotic and acyanotic congenital heart disease on children’s growth velocity

  • Dewi Awaliyah Ulfah Sebelas Maret University
  • Endang Dewi Lestari Sebelas Maret University
  • Harsono Salimo Sebelas Maret University
  • Sri Lilijanti Widjaya Sebelas Maret University
  • Bagus Artiko Sebelas Maret University
Keywords: congenital heart disease, growth velocity, failure to thrive


Background Congenital heart disease (CHD) can lead to failure to thrive. Decreased energy intake, malabsorption, increased energy requirements, and decreased growth factors (growth hormone/insulin-like growth factor 1 axis) are related to malnutrition and growth retardation in children with CHD.

Objective Tocompare the impact of cyanotic and acyanotic CHD on children’s growth velocity (using the 2009 WHO growth velocity chart).

Methods This study was conducted in patients less than 24 months of age with CHD in the Pediatric Cardiology Specialist Unit Dr. Moewardi Hospital, Surakarta, Central Java, from December 2016 to February 2017. Subjects’ weights were evaluated at the beginning of the study and two months later. Data were compared to the WHO Growth Velocity chart and analyzed by Chi-square test.

Results Of 46 patients with CHD (23 cyanotic, 23 acyanotic), 10 patients (21.7%) were identified with failure to thrive, i.e., < 5th percentile. Significantly more children with acyanotic CHD were in the >5th percentile for growth velocity than were children with cyanotic CHD (OR 5.600; 95%CI 1.038 to 30.204; P=0.032). Acute upper respiratory tract infection was not significantly associated with growth velocity (OR 2.273; 95%CI 0.545 to 9.479; P=0.253).

Conclusion Children with cyanotic CHD have 5.6 times higher risk of failure to thrive than children with acyanotic CHD.

Author Biographies

Dewi Awaliyah Ulfah, Sebelas Maret University
Pediatric Department
Endang Dewi Lestari, Sebelas Maret University
Pediatric Department
Harsono Salimo, Sebelas Maret University
Pediatric Department
Sri Lilijanti Widjaya, Sebelas Maret University
Pediatric Department
Bagus Artiko, Sebelas Maret University
Pediatric Department


1. Khan I, Muhammad A, Muhammad T. Pattern of congenital heart disease at Lady Reading Hospital Peshawar. Gomal J Med Sci. 2011;9:174-7.
2. Van der Linde D, Konings EE, Slager MA, Witsenburg M, Helbing WA, Takkenberg JJ, et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol. 2011;58:2241-7.
3. Richards AA, Garg V. Genetics of congenital heart disease. Curr Cardiol Rev. 2010;6:91-7.
4. Chen CW, Li CY, Wang JK. Growth and development of children with congenital heart disease. J Adv Nurs. 2004;47:260-9.
5. Irwanto, SA, Narendra MB. Penyimpangan tumbuh kembang anak. 29 July 2006. [cited 2016 January 17]. Available from:
6. Noble K, Forsey J. An analysis of growth failure in children with congenital heart disease. Welsh Paediatr J. 2010;32:13-6.
7. WHO. The WHO multicenter growth reference study (MGRS). 2009.
8. Hubschman LE. Malnutrition in congenital heart disease: management to improve outcomes. Infant, Child, and Adolescent Nutrition. 2013;5:170-6.
9. Batrawy SRE, Tolba OARE, El-Tahry AM, Soliman MA, Eltomy M, Habsa A. Bone age and nutritional status of toddlers with congenital heart disease. Res J Pharm Biol Chem Sci. 2015;3:940-9.
10. Eren E, Cakir EDP, Bostan O, Saglam H, Tarim O. Evaluation of the endocrine functions in pediatric patients with cyanotic congenital heart disease. Biomedical Res. 2013;24:77-81.
11. Al-Asy HM, Donia AA, El-Amrosy DM, Rabee E, Bendary AA. The levels of ghrelin in children with cyanotic and acyanotic congenital heart disease. J Pediatr Sci. 2012;6:e209.
12. Mahapatra A, Sarangi R, Mahapatra PP. Spectrum of congenital heart disease in a tertiary care centre of Eastern india. Int J Contemporary Pediatr. 2017;4:1-3.
13. Batte A, Lwabi P, Lubega S, Kiguli S, Otwombe K, Chimoyi L, et al. Wasting, underweight and stunting among children with congenital heart disease presenting at Mulago Hospital, Uganda. BMC Pediatr. 2017;17:10.
14. Nasiruzzaman AHM, Hussain MZ, Baki MA, Tayeb MA, Mollah MN. Growth and developmental status of children with congenital heart disease. Bangladesh Med J. 2011;40:54-57.
15. Atwa ZT, Safar HH. Outcome of congenital heart diseases in Egyptian children: is there gender disparity? Egypt Pediatr Assoc Gazette. 2014;62:35-40.
16. Vaidyanathan B, Nair SB, Sundaram KR, Babu UK, Shivaprakasha K, Rao SG, et al. Malnutrition in children with congenital heart disease (CHD) determinants and short term impact of corrective intervention. Indian Pediatr. 2008;45:541-6.
17. Harshangi SV, Itagi LN, Patil V, Vijayanath V. Clinical study of congenital heart disease in infants in tertiary care hospital. JPSI. 2013;2:15-8.
18. Artiko B. Percepatan pertumbuhan anak dengan patent ductus arteriosus sebelum dan sesudah kateterisasi penutupan [thesis]. [Surakarta]: Fakultas Kedokteran Universitas Sebelas Maret; 2015.
19. Gabriela K, Kuswiyanto RB, Dwiyatnaningrum F. Clinical characteristic and outcome of acute lower respiratory tract infection in children with congenital heart disease. Althea Med J. 2015;2:403-8.
20. Medrano Lopez C, Garcia-Guereta Silva L. Respiratory infections and congenital heart disease: two seasons of the CIVIC study. An Pediatr. 2007;67:329-36.
How to Cite
Ulfah D, Lestari E, Salimo H, Widjaya S, Artiko B. The effect of cyanotic and acyanotic congenital heart disease on children’s growth velocity. PI [Internet]. 22Jun.2017 [cited 17Apr.2024];57(3):160-. Available from:
Received 2017-04-10
Accepted 2017-06-15
Published 2017-06-22