Résumé
Purpose: to identify the incidence of malnutrition in the first year of life in infants with severe congenital heart disease (CHD), and the factors associated with this malnutrition. Methods and results: retrospective longitudinal multicentre study carried out from January 2014 to December 2020. 216 infants under the age of one with severe CHD (requiring cardiac surgery and/or cardiac catheterization and/or hospitalization for heart failure) were included. The pathophysiological classification (Thiene and Frescura’s) was used to classify CHD. The malnutrition defined by a Waterlow score under 80% and/or a ratio height for height expected for the age <85% and/or the need for calorie enrichment or nutritional support in the first year, was found in 43% of the infants. The highest prevalence of malnutrition (71%) was observed in infants with increased pulmonary blood flow (left-to-right shunts) compared with a prevalence under 30% in all the other pathophysiological groups. Heart failure in the first year of life (OR 9,26 IC[4.04;21.25], pCHD with increased pulmonary blood flow (OR 4,80 IC[1.42;16.20], p 0,08), a high number of hospitalizations (OR 1,35 IC [1.08l; 1.69], p=0,009) and a low weight at birth (OR 0,62 IC [0.44;0.89],p=0,009) were independent predictors of malnutrition in multivariate analysis. Conclusion: incidence of malnutrition in infants with severe CHD was high, specifically in CHD with increased pulmonary blood flow. To prevent the morbidity associated with malnutrition in this population of patients, the implementation of a standardized nutritional protocol is essential.