Potential Risk Factors of Developmental Cognitive Delay in the First Two Years of Life

Abstract

BACKGROUND: The first two years of life constitute a critical period of rapid change. The events during this phase prepare the child for subsequent developmental competency.AIM: To determine the potential risk factors that affect an infant’s cognitive development in the first two years of life in a sample of Egyptian infantsSUBJECTS AND METHODS: A cross-sectional comparative study included 655 male and female infants. Their age ranged from 3 – 24 months. Bayley Scales of Infant and Toddler Development (Bayley III) were used for cognitive assessment. Perinatal and nutritional data were recorded. Levels of serum Zinc, Copper, Iron, vitamin B12 and complete blood count (CBC) were assessed in a subsample of 193 infants.RESULTS: Infants having below the average cognitive composite score (CCS) represented 38.47% of the whole sample. The risk of having a low average (CCS) was determined by multiple factors. Poor maternal education and low family income were the most significant social risk factors (OR = 2.19, p = 0.0003; OR = 1.64, p = 0.002 respectively). Prematurity and complicated labor represented significant perinatal risks (OR = 1.22, p = 0.005; OR = 2.39, p =0.001respectively). Bottle feeding versus breastfeeding in the first six months of life was the most significant nutritional predictor of low average (CCS) (OR = 1.79, p = 0.001). Infants with low average (CCS) had significantly lower levels of serum zinc and vitamin B12 than those with average scores. CONCLUSION: Multiple factors appear to interact affecting the early cognitive development of Egyptian infants. Prematurity, complicated labour, poor maternal education, low family income and micronutrient deficiency are the main risk factors. Studying these factors is of great value in directing governmental intervention efforts.

Stunting and its Determinants among Governmental Primary School Children in Egypt: A School-based Cross-sectional Study

“…Skipping breakfast and having <3 meals per day carried more than 4 times the risk of being stunted than those who had breakfast and their number of meals were more than three per day. There are many Egyptian studies supporting these findings and at the same time suggesting that school feeding programs and breakfast resulted in improvements in children's health and nutrition when provided for a long period [6], [7], [8], [9], [10], [11].…”

“…Nutritional status is a strong determinant of health, neurocognitive performance, and school achievement of school-aged children [6], [7], [8], [9], [10], [11]. In addition to this, childhood undernutrition can impact adults' salaries and families' incomes [23].…”

“…Egypt is on course to meet the global targets of under-five stunting which is less than that of developing countries by 25% [29]. Such a target could not be achieved without educating mothers about the role of breastfeeding during the first 2 years of life in improving the health and development of infants [8], [9], [10], [11]. Meanwhile, to achieve SDG for decreasing stunting in Egypt, community-based programs for empowering women is indicated as it proved to be successful for rural communities in Egypt for controlling both communicable and non-communicable diseases and for enhancing progress toward a better quality of life [30], [31], [32], [33].…”

“…It was also hypothesized that more educated women in developing countries are more receptive or have a higher ability to understand information about child care and nutrition [8], [42], [43], [44] and are more able to maximize utilization of existing family and community resources for available governmental primary health care services [45], [46]. Moreover, the linkage between exclusive breastfeeding with higher levels of maternal education was documented among studies targeted infants and preschool children from developing countries [8], [9], [10], [11], [43]. Meanwhile, higher levels of maternal intelligence promote better offspring health as it influences increased usage of adaptive behavior strategies.…”

“…The physical growth and nutritional status of school-aged children are considered to be of utmost significance as it presents the general health status of the whole community. Good nutrition is also a determinant of healthy growth of mind and body in all stages of life, especially in the early stages of life [6], [7], [8], [9], [10], [11].…”