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The Prevalence of Malnutrition in Children With Congenital Heart Disease: A Meta-Analysis
Journal article   Peer reviewed

The Prevalence of Malnutrition in Children With Congenital Heart Disease: A Meta-Analysis

Jihye Lee, Harleah G. Buck, Pamela Mulder, Seok-yeong Hong, Teresa A. Marshall and Sandra Daack-Hirsch
Journal of pediatric health care, Vol.40(3), pp.e94-e104
05/2026
DOI: 10.1016/j.pedhc.2025.10.011
PMID: 41335075

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Abstract

•Meta-analysis estimated malnutrition prevalence in children with CHD.•Underweight, stunting, and wasting varied by age and malnutrition type.•Infants had highest underweight, stunting and wasting peaked in early childhood.•PAH significantly increased odds of all forms of malnutrition.•Findings support age- and disease-specific nutritional interventions in CHD. Although numerous studies have documented the high prevalence of malnutrition in children with congenital heart disease (CHD), variability in findings has made it difficult to estimate true risk. This meta-analysis aimed to estimate the pooled prevalence of malnutrition by age group and examine its association with CHD-specific disease characteristics. Following PRISMA guidelines, a meta-analysis was conducted to determine the pooled prevalence of underweight, stunting, and wasting, stratified by age group. The odds of malnutrition were also analyzed based on CHD disease characteristics. Thirty-seven studies were included. The pooled prevalence of underweight was 34.3% (N = 83,321), stunting 30.8% (N = 84,033), and wasting 25.5% (N = 72,283). Prevalence differed by age and malnutrition subtype: underweight was most common in infants (38.3%), while stunting (32.5%) and wasting (27.8%) were highest in the toddler-to-preschool age group. Children with pulmonary arterial hypertension (PAH) had significantly higher odds of being underweight (Odds Ratio, OR = 4.24), stunted (OR = 3.11), and wasted (OR = 1.32). Children with cyanosis also had elevated odds of stunting (OR = 1.38), though not statistically significant. Malnutrition is common among children with CHD and varies by malnutrition type, age group, and disease characteristics. The elevated risk in children with PAH and cyanosis suggests the importance of disease-specific monitoring and intervention strategies. Tailored approaches based on patient age and clinical profile may help improve growth outcomes in this vulnerable population.
 Congenital Heart Disease Failure To Thrive Growth Malnutrition Meta-analysis

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