Iron Status Profile of Children with Acyanotic Congenital Heart Disease at the Lagos State University Teaching Hospital

Abstract

Background: Children with acyanotic congenital heart diseases are prone to micronutrient and macronutrient deficiencies that worsen morbidity and mortality in affected individuals.  Nigeria has a high prevalence of children with congenital heart diseases.  Despite lower food fortification levels than in developed countries, there is no information on the burden of iron-deficiency anaemia in children with heart disease.  The current study evaluated the prevalence of iron deficiency among Nigerian children with acyanotic congenital heart disease. Methods: The study was cross-sectional and analytical, involving 59 subjects with acyanotic congenital heart disease and apparently healthy controls.  Red cell indices and serum iron status, including serum iron, Total Iron Binding Capacity (TIBC), and ferritin, were evaluated. Iron deficiency is indicated by low serum ferritin (<12 ng/L for children under five, <15 ng/L for those five and older), often with transferrin saturation below 16%, and reduced MCV and MCHC for age.  Iron deficiency anemia is diagnosed when hemoglobin is below the expected range for age, along with signs of iron deficiency.  Latent iron deficiency (iron depletion) is defined by serum ferritin below 20 ng/L across all ages. Results: Latent iron deficiency was observed in 13.6% of cases and 15.3% of controls. A total of 2 (3.4%) cases and 3 (5.1%) controls had iron deficiency.  No subject had iron deficiency anaemia (IDA). Conclusions: There is a risk of iron deficiency anaemia in both children with acyanotic congenital heart disease and apparently healthy children.  Due to the morbidity effect of IDA in children with congenital heart diseases, there is a need for screening and nutritional assessment for IDA in affected children.