Association of psychomotor development with feeding practices and nutritional status of 6-month-old infants in a peri-urban community of South Africa

摘要

Background: Inadequate nutrition during the first thousand days has long-term effects on growth and cognitive development. Stunted children usually experience delayed cognitive development, increased morbidity and mortality. Anaemia and iron deficiency as a result of micronutrient undernutrition remain problems of public health importance worldwide as it effects mental, motor and sociol-emotional development Methods: This study used baseline data of a randomized controlled trial to evaluate psychomotor development in relation to feeding practices and nutritional status of 6-month-old infants (n = 750) from a peri-urban community of South Africa. Psychomotor development was assessed by Kilifi Developmental Inventory and a South African parent rating scale. The weight-for-length (WLZ), length-for-age (LAZ) and weight-for-age z-scores (WAZ) were based on the WHO classification. Blood samples were analysed for haemoglobin (Hb), plasma ferritin (PF), and soluble transferrin receptor (sTfR). Socio-economic, breastfeeding and complementary feeding practices were assessed by questionnaire. Results: Stunting was prevalent in 28.5%, of infants. Multi-variable binary logistic regression showed that lower birth weight (OR 0.12, 95%CI 0.07 to 0.20, P< 0.001) and shorter maternal height (OR 0.94, 95%CI 0.91 to 0.98, P= 0.001) were inversely associated with stunting. The other factors associated with stunting were higher sTfR (mg/L) concentrations, lower Hb (g/dL) and low education level of the mother/ caregiver. Anaemic infants (36.5%) had lower scores for both eye-hand coordination (P< 0.001; d= 0.497) and locomotor activities (P< 0.001; d = 0.463). Scores for eye-hand coordination activities were also lower for infants suffering from iron deficiency anaemia. Stunted infants had significant lower parent rating scores (P= 0.001; d = 0.231). Conclusions: Multi linear regression analysis showed a significant positive correlation between haemoglobin concentration and eye-hand coordination, locomotor and combined psychomotor scores. Psychomotor development in relation to nutritional status and growth provide a more conclusive representation of infant psycho-motor development.