Assessment of neurodevelopmental abnormalities in children with severe acute malnutrition between the age of 6 months to 30 months

Abstract

Objectives : To assess the developmental abnormalities in Severe Acute Malnutrition using Developmental Assessment Scale for Indian Infants (DASII). Design: Hospital based Prospective Analytical Study. Setting : Department of Pediatrics, Kamla Raja Hospital, Gajra Raja Medical College, Gwalior. Participants: Children with severe acute malnutrition as per criteria of WHO between the age of 6 months and 30 months admitted in the hospital between March 2015 to January 2017. Method: Patients were first managed as per WHO guidelines of SAM. At the end of stabilization phase detailed neurological examination was done to look for neurological deficits by Development Assessment Scale for Indian Infants (DASII). Results: A total of 70 cases were enrolled. Mean Development Quotient for cases was 79.7(23.5) against a population mean of 112.28(10.7) (p 0.001). Motor Development Quotient was found to be 79.56(23.03) (p 0.001) and Mental Development Quotient was 79.90(26.075) (p 0.001). MUAC was found to have positive correlation with Motor DQ (p value 0.006) with patients having MUAC 11.5cm having motor DQ [74.7(24.1)] as compared to those having MUAC >11.5cm [91.5(16.4)]. On analyzing patients having stunting, it was found that a significant proportion of them had low Motor DQ (chi² 4.1, p value 0.023), low Mental DQ (chi² 2.9, p value 0.038), and low Mean DQ (chi² 3.1, p value 0.036) when compared to patients not having stunting. Conclusions : SAM patients have both low Mental DQ and Motor DQ. Low MUAC is associated with Low Motor DQ. Stunting is associated with low Motor and Mental DQ.