Resumen de Association between development level and nutritional status in children under 5 years of age in primary care

Miguel Angel Villasís-Keever, Antonio Rizzoli-Córdoba, Blanca B. Mares-Serratos, Karla E. Falcón-Millán, Edwin O. Vargas-Ávila, Christian A. Delaflor-Wagner, Daniel Aceves-Villagrán, Hortensia Reyes Morales, José A. García-Aranda

• español

  Resumen Introducción: La malnutrición es un factor de riesgo para anormalidades del desarrollo infantil. A pesar de ser un problema de salud pública, aún no se conoce el impacto que tiene el sobrepeso u obesidad en este aspecto. El objetivo es dar a conocer el impacto de la desnutrición, sobrepeso y obesidad sobre las alteraciones en el desarrollo de niños de 1-59 meses en áreas rurales/urbanas en México. Métodos: Se aplicó la prueba Evaluación del Desarrollo Infantil (EDI) a niños de 1-59 meses que acudieron a unidades de primer nivel de atención del estado de Guanajuato, entre 2013 y 2015. Se utilizó la clasificación de la OMS para determinar el estado de nutrición, tomando en cuenta la relación peso/estatura. Para determinar la asociación entre estado nutricional y desarrollo se calculó con razón de momios de prevalencia (RMP) mediante regresión logística, ajustada por sexo, edad, localidad y nivel de marginación. Resultados: Se incluyeron 34,972 participantes: 50.3% de sexo masculino, 39.5% de muy bajo nivel de marginación, 58.6% en localidades urbanas y 55.0% beneficiarios Prospera. Por edad, 31.9% de 1-12 meses; 17.5% de 13-24 meses; 16.3% de 25-36 meses y 34.3% de 37-59 meses. El estado nutricional: normal en el 85.8%, desnutrición 9.1% sobrepeso/obesidad 5.0%. 79.1% con desarrollo normal. RMP para desarrollo anormal: desnutrición leve 1.820 (IC 95% 1.671-1.981); desnutrición moderada 2.796 (IC 95% 2.195-3.562); desnutrición severa 14.903 (IC 95% 8.149-27.257); y 1.160 (IC 95% 1.030-1.307) para sobrepeso/obesidad. Conclusión: La desnutrición y el sobrepeso/obesidad son factores que incrementan el riesgo de problemas en el desarrollo en niños menores de cinco años.

• English

  Abstract Background: Malnutrition is a risk factor for childhood development disorders. Although undernutrition is recognized as a public health problem, the impact of overweight/obesity on childhood development remains unknown. The objective is to determine the effects of undernutrition, overweight, and obesity on development in children aged between 1 and 59 months in rural/urban areas of Mexico. Methods: The Childhood Development Evaluation (EDI, for its acronym in Spanish) test was administered to children 1-59 months of age who visited primary care units in Guanajuato State, Mexico, between 2013 and 2015. The World Health Organization classification (weight/height ratio) was used for nutritional status. Logistic regression adjusted by sex, age, rural/urban, and level of marginalization, used to calculate odds ratios (OR) to stablish the association between nutritional status and developmental outcomes. Results: 34,972 participants were included. 50.3% were male, 39.5% had a very low level of marginalization, 58.6% lived in urban areas, and 55.0% were beneficiaries of a conditional cash transfer program. Age distribution: 31.9% between 1 and 12 months old; 17.5% between 13 and 24 months old; 16.3% between 25 and 36 months old; and 34.3% between 37 and 59 months old. Overall 85.8% of participants had normal nutritional status, whereas 9.1% were identified as malnourished, and 5.0% were classified as overweight or obese. 79.1% had typical development. The OR for atypical development was 1.820 (95% confidence interval [95% CI], 1.671-1.981) for mild undernutrition; 2.796 (95% CI: 2.195-3.562) for moderate undernutrition; 14.903 (95% CI: 8.149-27.257) for severe undernutrition; and 1.160 (95% CI: 1.030-1.307) for overweight/obesity. Conclusion: Undernutrition and overweight/obesity are factors that increase the risk of developmental problems in children < 5 years of age.