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Neurodevelopment and Recovery From Wasting

Harriet M Babikako, Celine Bourdon1,2, Emmie Mbale1,3

  • 1Childhood Acute Illness and Nutrition Network, Nairobi, Kenya.

Pediatrics
|October 4, 2022
PubMed

Insights

Children’s neurodevelopment recovery parallels their physical recovery from malnutrition after acute illness. Stunting significantly impacts this recovery, highlighting the need for integrated care approaches.

Area of Science:

  • Child Health
  • Neurodevelopmental Outcomes
  • Malnutrition Research

Background:

  • Acute illness and malnutrition are leading causes of hospitalization for children in low- and middle-income countries.
  • Understanding the link between malnutrition recovery and child development is crucial for improving long-term health outcomes.

Purpose of the Study:

  • To investigate the association between wasting recovery trajectories and neurodevelopmental outcomes in young children after hospitalization for acute illness.
  • To identify factors influencing neurodevelopmental recovery in children recovering from acute illness and malnutrition.

Main Methods:

  • Prospective observational cohort study of children aged 2–23 months in Uganda, Malawi, and Pakistan.
  • Wasting recovery trajectories were determined by changes in mid-upper arm circumference-for-age z-score.
  • Neurodevelopment was assessed using the Malawi Developmental Assessment Tool (MDAT) development-for-age z-score (DAZ) at discharge and 6 months post-hospitalization.

Main Results:

  • Four wasting recovery trajectories were identified: high-stable, wasted-improved, severely wasted-greatly improved, and severely wasted-not improved.
  • Children with severe wasting who greatly improved showed a steep positive neurodevelopmental recovery slope, especially those also affected by stunting.
  • While children with wasting recovery showed no difference in neurodevelopmental scores compared to community children after 6 months, those who did not recover from wasting had significant developmental delays.

Conclusions:

  • Neurodevelopmental recovery in children convalescing from acute illness occurs in parallel with physical recovery from wasting.
  • Stunting significantly influences the trajectory of neurodevelopmental recovery in children experiencing malnutrition.
  • Early and effective management of wasting and stunting is critical for optimizing neurodevelopmental outcomes in children post-hospitalization.
Abstract

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