Developmental delay among children under two years of age in slums of Burdwan Municipality: A cross-sectional study

Prevalence and determinants of developmental delay among children in low- and middle-income countries: a systematic review and meta-analysis

Background

Developmental delay is a public health problem in low- and middle-income countries. However, there is no summarized evidence in low- and middle-income countries on developmental delay, and primary studies on this issue show varied and inconclusive results. This systematic review and meta-analysis aimed to assess the pooled magnitude of confirmed developmental delay and its determinants among children in low- and middle-income countries.

Methods

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to write this systematic review and meta-analysis. Primary studies were searched from PubMed, PsycINFO, Hinari, Science Direct, African Journal of Online, Web of Science, and Google Scholar databases. The Newcastle-Ottawa Scale, adapted for the cross-sectional studies, was used to assess the quality of the included studies. Heterogeneity and publication bias were assessed by the I2 and Eggers tests, respectively. Due to the high heterogeneity, the random effects model was used for analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to show the association between developmental delay and its determinants.

Results

The pooled prevalence of confirmed developmental delay was 18.83, 95% CI (15.53-22.12). In the subgroup analysis, a high prevalence of developmental delay [26.69% (95% CI, 15.78-37.60)] was observed in studies performed in Africa. Maternal education [3.04; 95% CI (2.05, 4.52)] and low birth weight [3.61; 95% CI (1.72, 7.57)] were significant determinants of developmental delay.

Conclusion

The pooled prevalence of developmental delay in low- and middle-income countries was high as compared to that in high-income countries. Maternal education level and weight at birth were significantly associated with developmental delays. Therefore, strategies should be designed to decrease the rate of low birth weight and the number of illiterate mothers living in low- and middle-income countries.

Systematic review registration

PROSPERO, CRD42024513060.

Identification of Preventable Risk Factors for Developmental Delay in Children: A Pilot Study

Purpose: Developmental delay (DD) is reported to be frequent in developing countries, such as India. Hence, this study was carried out to evaluate preventable risk factors that can predispose children to DD, through observations of pediatric neurology outpatients. Methods: This was a prospective, observational, and descriptive cross-sectional single-center hospital-based study for a period of 30 days, split into two separate time periods due to the impact of the coronavirus disease 2019 pandemic. Children who newly presented to the pediatric neurology outpatient department were considered. There were a total of 151 boys and girls, from 6 months to 14 years of age. Detailed demographic information on prenatal, natal and postnatal risk factors relevant to the neurological diagnosis was collected. Antenatal education for mothers about breastfeeding and newborn care, place of delivery, the availability of round-the-clock pediatric care during the delivery, gestational age, maternal fever, encephalitis, seizures, meningitis, blood pressure, gestational diabetes mellitus, infections, history of consanguinity, and genetic disorders were all considered. The data were analyzed with odds ratios and multivariable logistic regression. Results: Forty-three of the 151 enrolled children had DD. Significant associations were found between consanguinity and DD (adjusted odds ratio [AOR], 6.50; 95% confidence interval [CI], 1.96 to 21.51; P<0.002) and between prematurity and DD (AOR, 2.34; 95% CI, 1.07 to 5.13; P<0.033). Conclusion: This study shows that consanguineous marriages and prematurity predisposed children to DD when prenatal, natal, and postnatal risk factors were comprehensively considered.