Malnutrition and Mental Development: Is There a Sensitive Period? A Nested Case‐control Study

Abstract

To examine the possibility that there is an early sensitive period for the effects of malnutrition on cognitive development, three groups of children (N = 197) were recruited from a birth cohort with known growth characteristics in south-west Ethiopia (N = 1,563). All had initial weights > or = 2,500 g. Early growth falterers dropped in weight below the third centile (z < -1.88) of the NCHS/WHO reference population in the first 4 months. Late growth falterers were children not in the first group whose weights were below the third centile at 10 and 12 months. Controls were a stratified random sample with weights above the third centile throughout the first year. All children were tested blind at 2 years using the Bayley Scales of Infant Development, adapted for use in Ethiopia. Mean (SD) scores on the psychomotor scale were 10.2 (3.7) in the controls, 6.6 (4.2) in the early growth falterers, and 8.5 (4.3) in the late growth falterers. For the mental scale they were 28.9 (5.8), 22.6 (6.2), and 26.6 (6.1) respectively. Both overall differences were statistically significant at p < .001, and planned comparisons between the control and the combined growth faltering groups, and between the early and later growth faltering groups, showed that each difference was statistically significant for both scales. However, early weight faltering was associated with weight at the time of testing (r = .33), which was associated with scores both on the psychomotor (r = .53) and the mental scale (r = .49). After taking weight at the time of testing into account there was no additional effect attributable to the timing of growth faltering. In this population, therefore, early malnutrition does not have specific adverse effect beyond the contribution that it makes to enduring malnutrition over the first 2 years.

Influence of intrauterine and extrauterine growth on neurodevelopmental outcome of monozygotic twins

“…The present study provides evidence that the intrauterine factors that affect head circumference development can be modified during an early sensitive postnatal period (32). In our sample, specific adverse effect on cognitive function of infants born from twin gestations was associated with head circumference postnatal growth, indicating that the pattern of head circumference growth during infancy can influence cognition (33).…”

Hubungan Infantile Anorexia dengan Perkembangan Kognitif

“…Penelitian yang ada menunjukkan terdapat hubungan yang signifikan antara gangguan pertumbuhan dengan perkembangan dan kecerdasan anak. [8][9][10][11] Penelitian tentang hubungan infantile anorexia dengan perkembangan kognitif anak pernah dilakukan di Washington oleh Chatoor dkk 12 dengan hasil didapatkan hubungan bermakna di antara keduanya. Di Indonesia, penelitian tentang masalah ini belum pernah dilakukan sehingga mendorong untuk meneliti tentang hubungan antara gangguan makan infantile anorexia dengan perkembangan kognitif anak.…”

Epidemiologia nutricional

“…As duas primeiras, já comentadas anteriormente, estariam relacionadas a perdas diretas ou indiretas na produtividade do trabalho e do desempenho escolar por diminuição da capacidade física e da função cognitiva. Essas duas rotas refletem um custo econômico que pode ser constatado por meio de estudos que mostraram um aumento na renda em torno de 10% para cada ano de escolaridade (Vazir, Naidu & Vidyasagar, 1998;Drewett et al, 2001), ao passo que a terceira rota de perpetuação do ciclo da pobreza está relacionada a perdas econômicas como conseqüência de gastos com saúde e um custo direto da fome/desnutrição tem sido estimado entre vinte e trinta bilhões de dólares por ano em todo o mundo (SCN, 1997a).…”