Department of Pediatrics, AIIMS, Bhopal, India.
Department of Pediatrics, R. D. Gardi Medical College, Ujjain, India.
PLoS One. 2020 Jun 1;15(6):e0233949. doi: 10.1371/journal.pone.0233949. eCollection 2020.
Undernutrition leads to impaired psychosocial and cognitive development. This study explored the developmental status of children with complicated severe acute malnutrition (SAM) and correlated it with various risk factors for SAM.
We recruited 100 children with SAM and no other associated significant health issues during the recovery phase of treatment using the Bayley Scales of Infant and Toddler Development III prior to discharge from the nutritional rehabilitation unit in R D Gardi Medical College, Ujjain, Central India. We also assessed composite developmental scores, developmental age equivalents, and average differences in developmental age. Risk factors for developmental delay were identified in children with complicated SAM. The results revealed that 75%, 75%, and 63% of children with SAM exhibited delay in motor (mean score: 78.22), language (mean score: 83.97), and cognitive (mean score: 78.06) domains, respectively. A total of 63% children exhibited delay by an average of 4-7 months in the total developmental age. The proportion of children with delay in motor, language, and cognitive domains was determined. An increased risk of global developmental delay was observedin children with a low birth weight (adjusted odds ratio [aOR]: 18.06, 95%CI: 2.08-156.56; P = 0.009), having working mothers (aOR: 17.54, 95%CI: 3.02-102.59; P = 0.001), weight-for-age less than three standard deviations (aOR: 6.09, 95%CI: 1.08-34.10; P = 0.04), and presence of severe anemia (aOR: 16.34, 95%CI: 2.94-90.73; P = 0.001).
The results indicated that children with SAM exhibit developmental delay across all domains. Identifying multiple modifiable risk factors for developmental delay in children with SAM will be helpful in devising early interventional strategies in low-middle income countries; however, the exact timing of such interventions should be investigated.
营养不良会导致心理社会和认知发育受损。本研究探讨了复杂性严重急性营养不良（SAM）患儿的发育状况，并将其与 SAM 的各种危险因素相关联。
我们在印度中部乌贾因的 RD 加迪医学院营养康复病房出院前，使用贝利婴幼儿发育量表第三版（Bayley Scales of Infant and Toddler Development III）招募了 100 名在治疗恢复期无其他相关重大健康问题的 SAM 患儿。我们还评估了综合发育评分、发育年龄当量和发育年龄的平均差异。确定了复杂性 SAM 患儿发育迟缓的危险因素。结果显示，75%、75%和 63%的 SAM 患儿在运动（平均得分：78.22）、语言（平均得分：83.97）和认知（平均得分：78.06）领域存在发育迟缓。共有 63%的儿童在总发育年龄上平均延迟 4-7 个月。确定了在运动、语言和认知领域存在发育迟缓的儿童的比例。在低出生体重（调整后的优势比[aOR]：18.06，95%CI：2.08-156.56；P = 0.009）、母亲为职业女性（aOR：17.54，95%CI：3.02-102.59；P = 0.001）、体重与年龄小于三个标准差（aOR：6.09，95%CI：1.08-34.10；P = 0.04）和严重贫血（aOR：16.34，95%CI：2.94-90.73；P = 0.001）的患儿中，观察到全球发育迟缓的风险增加。
结果表明，SAM 患儿在所有领域均存在发育迟缓。确定 SAM 患儿发育迟缓的多个可改变危险因素，将有助于在中低收入国家制定早期干预策略；然而，应调查此类干预措施的确切时间。
