Comparative analysis of developmental profile between normal and severe acute malnourished under-five children in Pakistan: a multicentre cross-sectional study

BMJ Open. 2021 Aug 13;11(8):e048644. doi: 10.1136/bmjopen-2021-048644.


Objectives: This study aims to compare the developmental profile of severe acute malnourished (SAM) and normal under-five children and to find sociodemographic determinants accountable for their developmental disabilities.

Setting: We conducted a multi-centre cross-sectional study in three basic health units and one rural health centre in Pakistan.

Participants: 200 children (SAM and healthy) aged 6-59 months.

Primary and secondary measures: We screened for nutritional status and clinical complications. Children underwent for developmental assessment by Denver Development Screening Tool II. A pretested structured questionnaire on sociodemographic characteristics and nutrition was used for collecting data about determinants of developmental delay.

Results: We observed statistically significant differences in anthropometric measurements among SAM compared with normal nourished in weight, height, mid-upper arm circumference and weight-for-height z-scores. SAM serves as a significant risk factors (p<0.001) for delayed personal or social development (69% vs 11%; OR (95% CI)=18.01 (8.45 to 38.37)), delayed fine motor development (39% vs 8%; OR (95% CI)=7.35 (3.22 to 16.81)), delayed language development (32% vs 8%; OR (95% CI)=5.41 (2.35 to 12.48)), delayed gross motor development (34% vs 10%; OR (95% CI)=4.64 (2.14 to 10.05)) and delayed global development (66% vs 20%; OR (95% CI)=7.77 (4.09 to 14.74)). Applying logistic regression, personal or social development (p<0.001) and language development (p<0.05), under-five siblings was a risk factor, while among gross motor development, mother's educational status (p<0.05) was a significant risk factor for developmental delay.

Conclusions: Our analysis indicates that children with malnutrition have a high frequency of developmental delays. Missing maternal education and a higher number of under-five siblings are also potential risk factors for developmental delay.

Keywords: epidemiology; nutrition; public health.

Publication types

  • Multicenter Study

MeSH terms

  • Child
  • Child Nutrition Disorders* / epidemiology
  • Cross-Sectional Studies
  • Humans
  • Infant
  • Malnutrition*
  • Pakistan / epidemiology
  • Severe Acute Malnutrition*