Physical And Mental Development In Children With Congenital Heart Disease Under Different Feeding Patterns

Objective:To study the status of physical development and mental development in children with congenital heart disease(CHD)under different feeding modes.To analyze the influencing factors of physical and mental development in children with congenital heart disease so as to further demonstrate the importance of breastfeeding to the growth and development of infants and young children.To improve the nutritional status of children with congenital heart disease and promote physical fitness and mental development in children with congenital heart disease and promote breastfeeding provide theoretical basis and support.Method:This study screened from December 2016 to September 2017 in Nanjing Children’s Hospital cardiothoracic surgery admitted to patients with congenital heart disease in 360 cases,divided into physical development and mental development of two parts,evaluation of physical development 200 cases of children,evaluation of mental development in 160 cases of children.Investigate gender,age,birth weight,low birth weight,preterm delivery,pulmonary hypertension,outflow tract obstruction,cyanosis,pneumonia,heart failure,complex deformity,associated extracardiac deformities,living environment,living patterns,feeding patterns,methods of birth,mother’s education,Father’s education and other related information.(1)Physical development:Z score was used to evaluate the physical development of 200 children.According to different feeding methods,children were divided into breast milk group,mixed group,artificial group,parity group of children under different feeding Z score and low weight,weight loss,growth rate of children with children,the analysis includes Feeding factors,including many factors affecting the physical development of children with congenital heart disease levels.(2)Mental development:Bailey infant development scale was used to evaluate the intelligence development of 160 cases of children,according to different feeding methods of children will be divided into breast milk group,mixed group,artificial group,the parity of three groups of children In different feeding methods Bailey infant development scale score and mental development,the proportion of children with mental retardation,the analysis of many factors,including feeding methods on the mental development of children with congenital heart disease levels.Result:(1)Physical development studies:Slow physical development may occur in children with congenital heart disease.There were 61(30.5%)children with low birth weight(WAZ<-2),35(17.5%)had slow growth and 54 were(27%)wasting(WHZ<-2)in 200 children with congenital heart disease.At the test level of α = 0.05,the Z score was in breast milk group>Z score in mixed group>Z score in artificial group.In children with WAZ<-2,children with a HAZ<-2 had less WHZ<-2 in breast milk than those in a mixed group;those with WAZ<-2 had a risk of HAZ<-2 Children with WHZ<-2 in the mixed group were less than those in the artificial group;the difference was statistically significant(P<0.05 or P<0.001).Regression analysis of related factors in children with low birth weight showed that the main relevant factors were low birth weight(OR=3.844,95%CI=1.802-8.293),pulmonary hypertension(OR=5.697,95%CI=2.856-11.897),pneumonia(OR=2.203,95%CI=1.309-3.710);Regression analysis of related factors in children with slow growth showed that the main relevant factors were low birth weight(OR=4.141,95%CI=2.023-9.104),pulmonary hypertension(OR=2.403,95%CI=1.025-5.506),pneumonia(OR=3.396,95%CI=1.913-6.408);Regression analysis showed that the main relevant factor was pulmonary hypertension(OR=2.803,95%CI=1.611-5.102).(2)Mental development research:Mental retardation and mental retardation can occur in children with congenital heart disease.There were 34 cases(21.3%)with mental retardation and 69 cases(43.0%)with psychomotor retardation in 160 cases with congenital heart disease.At the test level of a = 0.05,the statistical analysis prompted a BSID score in breast milk group>BSID score in mixed group>BSID score in artificial group.Children with MDI developmental retardation,PDI developmental retardation in breast milk less than thoes in mixed group and artificial group,the difference was statistically significant(P<0.05 or P<0.001).Children with MDI developmental retardation,PDI developmental retardation in mixed group less than thoes in the artificial group,the difference was statistically significant(P<0.05 or P<0.001).Regression analysis of the related factors in children with mental retardation suggested that the main relevant factor was cyanosis(OR = 3.504,95%CI=1.513-8.296).Regression analysis of related factors in children with slow development of mental activity suggested that the main relevant factors were low birth weight(OR = 6.912,95%CI = 1.514-32.503)and cyanosis(OR = 2.504,95%CI=1.012-6.204).Conclusion:Children with congenital heart disease generally have slow physical development.Among them,there are 30.5%of children with low birth weight,17.5%of children with slow growth,and 27%of children with weight loss.The physical development of children with congenital heart disease breastfeeding is generally better than that of mixed feeding and artificial feeding.It suggests that breastfeeding has a great advantage in the physical development of children with congenital heart disease.Analysis shows that low birth weight,pneumonia and pulmonary hypertension are the three major risk factors affecting the physical development of infants with congenital heart disease,and the feeding mode is not the key factor affecting the physical development of children.However,in the merger of children with these diseases,breastfeeding can provide the necessary energy and immune substances,it is in the process of disease in children should provide breastfeeding as far as possible.Reasonable feeding patterns and reasonable and effective nutritional support can reduce the risk of other related diseases.Children with congenital heart disease generally have slow mental development,of which children with mental retardation accounted for about 21.3%,mental retardation in children accounted for about 43.0%.The rate of mental development in children with congenital heart disease breastfeeding is generally superior to that of mixed feeding and artificial feeding.It suggests that breastfeeding accounts for a greater advantage in the mental development of children with congenital heart disease.Cyanosis and low birth weight are the key factors that influence the mental development of infants with congenital heart disease,and the feeding mode is not the key factor that affects the mental development of children.Therefore,the risk factors for intellectual development of children with congenital heart disease early intervention,the provision of long-term and stable breastfeeding,scientific supplementary food supplement,can better promote congenital heart disease infants mental improvement.