Psychosocial Outcome and CT Findings after Gross Undernourishment during Infancy: a 20‐year Developmental Study

Abstract

SUMMARY This prospective 20‐year follow‐up study contrasts the development of a group of 20 children grossly undernourished during infancy (index group) with that of a matched control group. There were significant differences between two groups in head circumference, height, weight, full‐scale IQ, verbal quotient, non‐verbal quotient and in visuo‐motor perceptual function. Despite their disadvantages, the index group have integrated effectively into the community, and their children have not experienced the nutritional deprivation they suffered during their own childhoods. RÉSUMÉ Etude de développement sur vingt ans du devenir psychosocial et des données de tomodensitométrie cérébrale de sujets sévérement sous‐nutrits durant la premiére enfance Cette étude longitudinale prospective sur 20 ans oppose le développement d'un groupe de 20 enfants sévérement sous‐nutrits durant la premiére enfance (groupe index) avec celui d'un groupe contrôle apparié. Les différences significatives entre les groupes index et contrôle en tour de tête, taille, poids, quotients intellectuels généraux, verbaux et non verbaux, en fonction perceptive visuomotrice mesurée au test de Bender et au dessin du Bonhomme sont discutées. L'étude montre qu'en dépit de leurs désavantages, les sujets du groupe index se sont intégrés plus efficacement dans la communauté et que leurs enfants n'ont pas eu á souffrir de la déprivation nutritionnelle qu'ils avaient subie durant leur propre enfance. ZUSAMMENFASSUNG Eine zwanzigjährige Entwicklungsstudie über die psychosozialen Ergebnisse und Befunde der Hirntomogramme von Patienten, die in ihrer Kindheit schwer unterernährt waren Diese zwanzigjährige Verlaufsstudie stellt die Entwicklung einer Gruppe von 20 in ihrer Kindheit schwer unterernährten Kindern (Index‐Gruppe) der einer entsprechenden Kontrollgruppe gegenüber. Die signifikanten Unterschiede zwischen der Index‐Gruppe und der Kontrollgruppe hinsichtlich Kopfumfang, Größe, Gewicht, Gesamtquotients, Verbalquotient, Nicht‐Verbal‐quotient und visuell motorischem Perzeptionsvermögen, was anhand des Bender Tests und anhand von Zeichnungen von Menschen beurteilt wurde, werden diskutiert. Die Studie zeigt, daß die Index‐Gruppe sich trotz ihrer Nachteile besser in die Gesellschaft integriert hat und daß ihre Kinder keine Unterernährung erfahren, die sie in ihrer eigenen Kindheit erlitten haben. RESUMEN Estudio del desarrollo en veinte anos de la situacion psicosocial conseguida y los hallazgos con la TAC en sujetos que habian sufrido una desnutricion importante en la lactancia Este estudio prospectivo de 20 años compara el desarrollo de un grupo de 20 niños con marcada desnutricion durante su lactancia (grupo indice) con el de un grupo control. Se discuten las diferencias significativas entre los dos grupos en el perimetro craneal, peso, estatura, cocientes verbal y no verbal y función perseptiva viso‐motora en el test de Bender y en los dibujos de figura humana. El estudio muestra que, a pesar de sus desventajas, el grupo indice se habia integrado más efectiv...

Twelve-year follow-up study of the impact of nutritional status at the onset of elementary school on later educational situation of Chilean school-age children

“…Similar results were observed when quantitating the impact of the nutritional status upon SA and IA assessed through the Raven Progressive Matrices Test, HC being the most important anthropometric parameter (Ivanovic et al, 1996(Ivanovic et al, , 2000bToro et al, 1998). It has been defined as the most sensitive anthropometric marker of prolonged undernutrition during infancy, associated with decreased SA and IA (Stoch et al, 1982;Ivanovic et al, 2000bIvanovic et al, , 2004a.…”

Nutritional status and performance in test of verbal and non-verbal intelligence in 6 year old children

“…These factors have been controlled in some studies. The effect of nutritional status on intelligence quotient (IQ) in young South-Africans was studied adjusting for maternal socio-economic level and head circumference (Stoch, Smythe, Moodie, & Bradshaw, 1982). Other studies have controlled genetic factors, in estimating the difference in IQ in brothers who had different nutritional status during lactation (Birch, Pineiro, Alcalde, Toca, & Cravioto, 1971) or between monozygotic twins of different birth weight (Lynn, 1993).…”

Variation in Feeding Practices following the Norwood Procedure

“…The pattern of poor growth following the Norwood procedure has been well described (1–4) with the poorest growth occurring during the early post-operative period and the interstage period, the time between hospital discharge following the Norwood procedure, and the performance of the volume unloading superior cavopulmonary anastomosis (stage II procedure). Both poor growth during early infancy and longer hospitalizations are risk factors for poor neurodevelopmental outcome (6–8) and increased late mortality (9). …”