Abstract
200 million pre-school age children are not developing properly. Delays in child development are associated with multiple factors. This study aims to analyze if vitamin A supplementation is associated with improved development and how this effect could be mediated by nutritional status. Population-based study surveyed a representative sample of 8000 households, 1232 children 0-35 months, in the state of Ceará, Brazil. The variables analysed included child developmental status, nutritional determinants and confounding factors. The main effects and interactions were evaluated using Cox regressive models. Vitamin A supplementation showed protective effect to delay in cognitive and motor development modified by interaction with nutritional status. While well-nourished supplemented children presented a 67% lower risk of cognitive delay (adjusted PRR = 0·33 [0·21-0·53]), stunted children had no benefit from supplementation (adjusted PRR = 0·97 [0·39-2·40]). Vitamin A supplementation has a protective effect on child development, but not in stunted children. This suggests that supplementation is effective in promoting child development, especially if associated to a joint effort to improve the nutritional status of children, given the importance of this mediator.
Highlights
MethodsIt is estimated that, worldwide, over 200 million pre-school age children are not developing properly[1]
This study aims to analyze if vitamin A supplementation is associated with improved development and how this effect could be mediated by nutritional status
Supplementation with vitamin A showed a strong protective effect: it was inversely associated with the three forms of delay studied
Summary
MethodsIt is estimated that, worldwide, over 200 million pre-school age children are not developing properly[1]. There are few population estimates of child developmental delay, it is believed that the vast majority of cases occur in developing countries[2,3]. Children who do not reach their full development do not achieve adequate learning, behavior, and mental and physical wellbeing; display poorer performance at school; and earn lower wages as adults. This perpetuates a cycle of poverty and continuously impaired human development[5,6]. Of the recognized contributing factors, child undernutrition and micronutrient deficiency[9] are often cited as the most important, and the specific deleterious effect of malnutrition on child development has broad scientific confirmation[10,11,12,13]. The effect of micro-nutrients, such as folic acid, iron, iodine, and vitamin A have been investigated in several studies[14], with clear relationships directly observed for iron[15] and iodine deficiency[16]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call