Study on impact of protein energy malnutrition on development in children


  • Dhara Patel Department of Paediatrics, GMERS Medical College and Hospital, Gandhinagar, Gujarat, India
  • Greeshma Issac Clinical fellow in PICU, Great Ormond Street Children's hospital, London, UK



Development delay, DDST-II, Malnutrition, MUAC, Protein energy, Weight


Background: Majority of the children in India who live below the poverty line in an environment of deprivation and starvation have physical and developmental retardation. The Objective of this study to study the impact and comparison of protein energy malnutrition on the development with normal children.

Methods: This was a hospital based cross sectional study in which total 128 cases of protein energy malnutrition and 30 normal children were enrolled from nutritional rehabilitation center and in patients wards. The study population comprised of children less than 5 years of age, having weight for height/length ≤3 SD, with visible wasting, or bipedal oedema, with mid arm circumference <11.5 cm were assessed for their development in all four domains using Denver II developmental Screening Test (DDST-II).

Results: The gross motor milestones are affected in 62.5% with grade4 PEM & 42.85% with grade 3, the fine motor component is affected more in grade 4 with other domains less affected, no significant relation of language delay with PEM was observed in this study, 40% of children with grade 4 PEM shows delay in social domain while 18.18% of the patients with grade 3 PEM show delay in social domain. No patients with grade 1 or grade 2 PEM showed delay in social domain. All four domains are affected in PEM with a maximum effect in gross motor, but the difference does not seem to be significant as the p value is 0.3 i.e.  >0.05 which is insignificant.

Conclusions: My study on the effect of protein energy malnutrition on development proves that there in increasing delay in all the domains of development with increasing grade of malnutrition. Early detection of malnutrition in community can cause early intervention and increase the productivity of nation.


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