Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Maternal Nutrition, Infants and Children

The mental development and behavior of low-birth-weight Bangladeshi infants from an urban low-income community

European Journal of Clinical Nutrition volume 66, pages 237–243 (2012)Cite this article

Abstract

Background/Objectives:

Adverse developmental consequences of low-birth-weight (LBW) infants have been frequently reported from developed countries where most of them are preterm. Few reports are available from developing countries, where the problem is huge and newborns are mostly term babies. We aimed to compare mental and psychomotor development and behavior of LBW Bangladeshi infants with those of normal-birth-weight (NBW) infants.

Subject/Methods:

Secondary data analyses from a randomized controlled trial of fish oil supplementation during pregnancy on infants' development at 10 month. There was no effect of supplementation on infants' development. All LBW (n=66) and NBW (n=183) infants were assessed for their mental development index (MDI), psychomotor development index (PDI), behavior and quality of psychosocial stimulation received at home. Socioeconomic information and anthropometric measurements were available, and bivariate and multivariate analyses were performed to examine group differences.

Results:

LBW infants scored significantly lower than NBW infants on MDI, PDI, activity and emotional tone. They came from comparatively poorer families and had lower gestational age than the NBW infants. After controlling for possible confounders, the NBW infants had significantly higher MDI (B=2.7, s.e.=1.1, 95% confidence interval (CI): 0.6–4.8), PDI (B=3.5, s.e.=1.3, 95% CI: 1.0–6.0) and activity (B=0.5, s.e.=0.2, 95% CI: 0.1–0.9) scores. Furthermore, in a subgroup analyses, a consistent pattern of developmental delay was also noted in favor of term-LBW infants.

Conclusions:

In a poor-urban Bangladeshi community, LBW infants had significantly lower mental and psychomotor developments and were less active than NBW infants at 10 months of age.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  • Anderson PJ, Doyle LW (2008). Cognitive and educational deficits in children born extremely preterm. Semin Perinatol 32, 51–58.

    Article  PubMed  Google Scholar 

  • Aylward GP, Pfeiffer SI, Wright A, Verhulst SJ (1989). Outcome studies of low birth weight infants published in the last decade: a metaanalysis. J Pediatr 115, 515–520.

    Article  CAS  PubMed  Google Scholar 

  • Bayley N (1993). Bayley Scales of Infant Development, 3rd edn. The Psychological corporation: San Antonio, TX.

    Google Scholar 

  • Black MM, Baqui AH, Zaman K, Persson LA, Arifeen SE, Le K et al. (2004). Iron and zinc supplementation promote motor development and exploratory behavior among Bangladeshi infants. Am J Clin Nutr 80, 903–910.

    Article  CAS  PubMed  Google Scholar 

  • Caldwell BM (1967). Descriptive evaluation of child development and of developmental settings. Pediatrics 40, 46–52.

    CAS  PubMed  Google Scholar 

  • Fattal-Valevski A, Leitner Y, Kutai M, Tal-Posener E, Tomer A, Lieberman D et al. (1999). Neurodevelopmental outcome in children with intrauterine growth retardation: a 3-year follow-up. J Child Neurol 14, 724–727.

    Article  CAS  PubMed  Google Scholar 

  • Fitzhardinge PM, Steven EM (1972). The small-for-date infant. II. Neurological and intellectual sequelae. Pediatrics 50, 50–57.

    CAS  PubMed  Google Scholar 

  • Gardner JM, Walker SP, Powell CA, Grantham-McGregor S (2003). A randomized controlled trial of a home-visiting intervention on cognition and behavior in term low birth weight infants. J Pediatr 143, 634–639.

    Article  PubMed  Google Scholar 

  • Gorman KS, Pollitt E (1992). Relationship between bodyweight and body proportionality at birth, growth during the first year of life, and cognitive development at 36, 48, and 60 months. Infant Behav Dev 15, 279–296.

    Article  Google Scholar 

  • Grantham-McGregor SM (1998). Small for gestational age, term babies, in the first six years of life. Eur J Clin Nutr 52 (Suppl 1), S59–S64.

    PubMed  Google Scholar 

  • Grantham-McGregor SM, Fernald LC (1999). Shethuraman K effects of health and nutrition on cognitive and behavioral development in children in the first three years of life. Food Nutr Bull 20, 53–98.

    Article  Google Scholar 

  • Grantham-McGregor SM, Lira PIC, Ashworth A, Morris SS, Assuncao AMS (1998). The development of low birth weight term infants and effects of the environment in Northeast Brazil. J Pediatr 132, 661–666.

    Article  CAS  PubMed  Google Scholar 

  • Hamadani J, Fuchs GJ, Osendarp SJM, Huda SN, Grantham-McGregor SM (2002). Zinc supplementation during pregnancy and effects on mental development and behavior of infants: a follow-up study. Lancet 360, 290–294.

    Article  CAS  PubMed  Google Scholar 

  • Hamadani J, Fuchs GJ, Osendarp SJM, Khatun F, Huda SN, Grantham-McGregor SM (2001). Randomised controlled trial of the effect of zinc supplementation on the mental development of Bangladeshi infants. Am J Clin Nutr 74, 381–386.

    Article  CAS  PubMed  Google Scholar 

  • Jiang ZD, Wu YY, Zhen MS, Sun DK, Feng LY, Peng YM et al. (1991). Development of early and late brainstem conduction time in normal and intrauterine growth retarded children. Acta Paediatr Scand 80, 494–499.

    Article  CAS  PubMed  Google Scholar 

  • Kardjati S, Kusin JA, De With C, Renqvist UH (1991). Low birth weight babies under village conditions: feeding pattern, growth and motor development. Paediatr Indones 31, 84–98.

    CAS  PubMed  Google Scholar 

  • Lasky RE, Lechtig A, Delgado H, Klein RE, Engle P, Yarbrough C et al. (1975). Birth weight and psychomotor performance in rural Guatemala. Am J Dis Child 129, 566–569.

    CAS  PubMed  Google Scholar 

  • Leitner Y, Fattal-Valevski A, Geva R, Bassan H, Posner E, Kutai M et al. (2000). Six-year follow-up of children with intrauterine growth retardation: long-term, prospective study. J Child Neurol 15, 781–786.

    Article  CAS  PubMed  Google Scholar 

  • Low JA, Handley-Derry MH, Burke SO, Peters RD, Pater EA, Killen HL et al. (1992). Association of intrauterine fetal growth retardation and learning deficits at age 9–11 years. Am J Obstet Gynecol 167, 1499–1505.

    Article  CAS  PubMed  Google Scholar 

  • Lundgren EM, Tuvemo T (2008). Effects of being born small for gestational age on long-term intellectual performance. Best Pract Res Clin Endocrinol Metab 22, 477–488.

    Article  PubMed  Google Scholar 

  • Padidela RNR, Bhat V (2003). Neurobehavioral assessment of appropriate for gestational and small for gestational age babies. Indian Ped 40, 1063–1068.

    Google Scholar 

  • Parkinson C, Wallis S, Harvey D (1986). School achievement and behavior of children who were small-for-dates at birth. Dev Med Child Neurol 28, 498–505.

    Article  CAS  PubMed  Google Scholar 

  • Paz I, Gale R, Laor A, Danon YL, Stevenson DK, Seidman DS (1995). The cognitive outcome of full-term small for gestational age infants at late adolescence. Obstet Gynecol 85, 452–456.

    Article  CAS  PubMed  Google Scholar 

  • Pryor J, Silva PA, Brooke M (1995). Growth, development and behaviour in adolescents born small-for-gestational-age. J Paediatr Child Health 31, 403–407.

    Article  CAS  PubMed  Google Scholar 

  • Pryor JE (1992). Physical and developmental status of preschool small-for-gestational-age children: a comparative study. J Paediatr Child Health 28, 162–167.

    Article  CAS  PubMed  Google Scholar 

  • Roth S, Chang TC, Robson S, Spencer JA, Wyatt JS, Stewart AL (1999). The neurodevelopmental outcome of term infants with different intrauterine growth characteristics. Early Hum Dev 55, 39–50.

    Article  CAS  PubMed  Google Scholar 

  • Tandon A, Kumari S, Ramji S, Malik A, Singh S, Nigam VR (2000). Intellectual psycho-educational and functional status of low birth weight survivors beyond 5 years of age. Indian J Pediatr 67, 791–796.

    Article  CAS  PubMed  Google Scholar 

  • Tofail F, Kabir I, Hamadani JD, Chowdhury F, Yesmin S, Mehreen F et al. (2006). Supplementation of fish-oil and soy-oil during pregnancy and psychomotor development of infants. J Health Popul Nutr 24, 48–56.

    PubMed  Google Scholar 

  • United Nations Children's Fund and World Health Organization (2004). Low Birthweight: Country, Regional and Global Estimates. UNICEF: New York, pp 1–27. http://www.childinfo.org/files/low_birthweight_from_EY.pdf (accessed 11 August 2010).

  • Valero De Bernabé J, Soriano T, Albaladejo R, Juarranz M, Calle ME, Martínez D et al. (2004). Risk factors for low birth weight: a review. Eur J Obstet Gynecol Reprod Biol 116, 3–15.

    Article  PubMed  Google Scholar 

  • Villar J, Smeriglio V, Martorell R, Brown CH, Klein RE. (1984). Heterogeneous growth and mental development of intrauterine growth-retarded infants during the first 3 years of life. Pediatrics 74, 783–791.

    CAS  PubMed  Google Scholar 

  • Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L et al. (2008. Maternal and Child Undernutrition Study Group. Maternal and child undernutrition: consequences for adult health and human capital. Lancet 371, 340–357.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Walker SP, Chang SM, Powell CA, Grantham-McGregor SM (2004). Psychosocial intervention improves the development of term low-birth-weight infants. J Nutr 134, 1417–1423.

    Article  CAS  PubMed  Google Scholar 

  • Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E et al. (2007). International Child Development Steering Group. Child development: risk factors for adverse outcomes in developing countries. Lancet 369, 145–157.

    Article  PubMed  Google Scholar 

  • Westwood M, Kramer MS, Munz D, Lovett JM, Watters GV. (1983). Growth and development of full-term nonasphyxiated small-for-gestational-age newborns: follow-up through adolescence. Pediatrics 71, 376–382.

    CAS  PubMed  Google Scholar 

  • WHO Multicentre Growth Reference Study Group (2006). WHO Child Growth Standards: Methods and Development. World Health Organization: Geneva. Available at: http://www.who.int/childgrowth/ (accessed 14 June 2010).

  • Wolke D, Skuse D, Mathisen V. (1990). Behavioral style in failure to thrive infants: a preliminary communication. J Ped Psychol 15, 237–254.

    Article  CAS  Google Scholar 

  • Zwicker JG, Harris SR (2008). Quality of life of formerly preterm and very low birth weight infants from preschool age to adulthood: a systematic review. Pediatrics 121, e366–e376.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

ICDDR,B acknowledges with gratitude the commitment of the World Bank to the Centre's research efforts. We are grateful to the mothers and children who participated in the study; without their help this research could not have been possible. This research was funded by the World Bank (Grant no. 00251).

Author information

Authors and Affiliations

  1. Child Development Unit, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh

    F Tofail, J D Hamadani & F Mehrin

  2. Department of Pathology, Bangladesh International Medical College, Dhaka, Bangladesh

    A Z T Ahmed

  3. Department of Neurology, Suhrawardi Medical College, Dhaka, Bangladesh

    M Hakim

  4. Institute of Nutrition & Food Science, University of Dhaka, Dhaka, Bangladesh

    S N Huda

Authors
  1. F Tofail
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J D Hamadani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A Z T Ahmed
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F Mehrin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M Hakim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S N Huda
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F Tofail.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Guarantors: Syed N Huda and Jena D Hamadani.

Contributors: The hypothesis for the secondary data analyses was developed by FT, JDH and SNH. The fieldwork was conducted and supervised by FM, FT and JDH by the help of other supporting staff. FT, JDH, AZTA, MH and SNH did the statistical analysis. FT wrote the first draft and coordinated completion of the paper with JDH, AZTA, MH and SNH. FT had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors critically commented on and edited earlier drafts and approved the final version of the paper.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tofail, F., Hamadani, J., Ahmed, A. et al. The mental development and behavior of low-birth-weight Bangladeshi infants from an urban low-income community. Eur J Clin Nutr 66, 237–243 (2012). https://doi.org/10.1038/ejcn.2011.165

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2011.165

Keywords

This article is cited by

Search

Advanced search

Quick links