Association between Anemia and Stunting among Children with Congenital Heart Disease: A Retrospective Study

Abstract Background: The impact of stunting varies based on the severity of tissue hypoxemia and the degree of physiological adaptation. Anemia is common in children with congenital heart disease (CHD). Early detection and intervention of stunting in children with anemia related to CHD can improve the children’s future and quality of life. Objective: This study aimed to assess the association between anemia and other factors contributing to stunting among children with CHD. In addition, we proposed to report the prevalence of iron-deficiency anemia (IDA) based on a combination of the Mentzer index, red cell distribution width, and mean corpuscular volume among CHD children. Method: A cross-sectional study was conducted at the pediatric cardiology outpatient department of a tertiary hospital in Bali, Indonesia. Children aged 1–60 months with CHD were included in this study. Child with syndromes were excluded. Both bivariate and multivariate analysis were conducted using SPSS 26.0. Results: A total of 313 children were analyzed with a mean age of 25.6 months. Stunting was found in 80 (25.6%). Stunting in CHD children was significantly associated with anemia (81.2% vs. 57.5%, P < 0.001. Prevalence ratio [PR] and 95% confidence interval [CI]: 3.12 [1.668–5.834]) and pulmonary hypertension (PH) (37.5% vs. 19.3%, P = 0.003. PR and 95% CI: 2.42 [1.367–4.291]). IDA was determined using a complete blood count and was found at 35.9% in the stunting groups. Conclusions: Stunting occurred in 25.6% among CHD patients and was significantly associated with anemia and PH in children with CHD.