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Dissertation
Growth failure in children with congenital heart disease
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Summer 2024
DOI: 10.25820/etd.007607
Abstract
Background: Congenital heart disease (CHD) is the most common congenital anomaly. Impaired cardiac function can disrupt the balance between energy intake and expenditure, potentially leading to growth failure. However, due to the multifactorial nature of somatic growth and the diverse characteristics of CHD, the relationship between CHD and growth failure is not fully understood.
Purpose: This study aims to provide a comprehensive understanding of growth failure in children with CHD through a scoping review, an evaluation of the relationship between CHD and growth failure while controlling for genetic and environmental factors, and an estimation of the pooled prevalence of growth failure.
Methods: The study consists of three parts. In Chapter 2, a scoping review was conducted to map out the factors influencing growth failure in children with CHD. In Chapter 3, anthropometric data from 41 pairs of twins were analyzed to evaluate the relationship between CHD and growth failure. Lastly, a meta-analysis (Chapter 4) was performed following PRISMA guidelines to estimate the pooled prevalence of growth failure and the individual odds of growth failure based on disease characteristics, including cyanosis, pulmonary arterial hypertension (PAH), and heart failure. A comprehensive literature search was conducted using databases such as PubMed, MEDLINE, CINAHL, EMBASE, and Web of Science.
Results: In Chapter 2, a scoping review found that CHD increases the risk of growth failure by increasing energy expenditure, reducing nutrient intake and absorption, and affecting endocrine function. Based on this review, a knowledge map was constructed to explain growth failure in children with CHD. In Chapter 3, the CHD group showed a significant decrease in growth parameters from the age of 1 year, with a higher prevalence of growth failure (46.3%) v compared to the non-CHD group (7.5%). The meta-analysis (Chapter 4) revealed an overall pooled prevalence of 27.9% for underweight, 26.8% for stunting, and 22.4% for wasting among children with CHD, with variations across age groups and disease characteristics. Children with PAH were more likely to experience all types of growth failure, and children with cyanosis had higher odds of stunting.
Conclusion: The high prevalence of growth failure in children with CHD supports that CHD increases the risk of growth failure. The relationship between CHD and growth failure is influenced by various disease characteristics, necessitating a tailored approach to risk assessment and intervention strategies. Understanding these factors can help promote optimal growth and address the healthcare needs of groups at high risk for growth failure.
Details
- Title: Subtitle
- Growth failure in children with congenital heart disease
- Creators
- Jihye Lee
- Contributors
- Sandra Daack-Hirsch (Advisor)Teresa A Marshall (Committee Member)Harleah G Buck (Committee Member)Pamela J Mulder (Committee Member)
- Resource Type
- Dissertation
- Degree Awarded
- Doctor of Philosophy (PhD), University of Iowa
- Degree in
- Nursing
- Date degree season
- Summer 2024
- Publisher
- University of Iowa
- DOI
- 10.25820/etd.007607
- Number of pages
- xi, 92 pages
- Copyright
- Copyright 2024 Jihye Lee
- Language
- English
- Date submitted
- 07/18/2024
- Description illustrations
- illustrations, tables
- Description bibliographic
- Includes bibliographical references (pages 78-92).
- Public Abstract (ETD)
- Congenital heart disease (CHD) is the most common congenital anomaly, and its structural and functional impairments increase the risk of growth failure. Growth failure has significant clinical implications as it affects disease prognosis, future development, and the psychosocial functioning of children with CHD. However, due to the multifactorial nature of somatic growth and the diverse characteristics of CHD, the relationship between CHD and growth failure has not been fully evaluated. To address this research gap, the first scoping review study (Chapter 2) focused on growth failure in children with CHD. The second study (Chapter 3) examined the relationship between CHD and growth failure by controlling for environmental and genetic influences. The last study (Chapter 4) estimated the prevalence of growth failure in children with CHD and assessed the risk of growth failure according to disease characteristics. This comprehensive approach aimed to better understand the risk of growth failure in children with CHD and improve interventions by identifying high-risk children.
- Academic Unit
- Nursing
- Record Identifier
- 9984698249802771
Metrics
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