Maternal stress, toxico-nutritional status and early child neurodevelopment in Konzo areas

Abstract

Objective:
To determine whether maternal stress is associated with poor early child neurodevelopment in konzo areas.
Subjects and methods:
A cross-sectional study including 114 mother and child dyads of children below 5 years of age living in Kahemba, Democratic Republic of Congo was conducted. Information related to maternal stress during pregnancy and delivery were collected through interview with selected instrument to detect symptoms of anxiety and depression. Early child neurodevelopment was assessed using the Gensini-Gavito and the Mullen Scale of Early Learning. Anthropometrics measurement were done to collect information on children nutritional status determined by the Height-for-Age Z score (HAZ score). Levels of cyanogen exposure were determined from the urine and the cassava flour that is used in the households. Statistical analyses were done using general linear models to assess level of association between variables.
Results:
More than half of children presented with a psychomotor developmental quotient (PDQ) below 100%. Predictors of PDQ were age of children (p = 0.048) and maternal stress (p = 0.031) contrary to nutritional status measured by the HAZ score (p <0.001). In Konzo affected households, maternal stress (p = 0.033) and level of cyanide (p = 0.007) in the cassava flour) were negative predictors against the HAZ score (p <0.001). The HAZ score remained the only factor positive predictor of early cognitive development (p <0.001).
Conclusion:
Prenatal maternal stress, undernutrition and cyanogenic exposure from toxic cassava are important predictors of poor early child neurodevelopment in konzo areas.