Vol 14: Impact of caste on the neurodevelopment of young children from birth to 36 months of age: a birth cohort study in Chitwan Valley, Nepal.Report as inadecuate



 Vol 14: Impact of caste on the neurodevelopment of young children from birth to 36 months of age: a birth cohort study in Chitwan Valley, Nepal.


Vol 14: Impact of caste on the neurodevelopment of young children from birth to 36 months of age: a birth cohort study in Chitwan Valley, Nepal. - Download this document for free, or read online. Document in PDF available to download.

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This article is from BMC Pediatrics, volume 14.AbstractBackground: Caste, a proxy of socioeconomic position, can influence the neurodevelopment of children through several pathways, including exposure to toxic elements. Studies from developing countries where caste is represented by prevailing caste groups and people are highly exposed to toxic elements can provide useful insights into the mechanisms of neurodevelopmental inequities among children. This study aims to investigate the impact of caste on the neurodevelopment of children from birth to 36 months of age in Chitwan Valley, Nepal, where people are exposed to high levels of arsenic As and lead Pb. Methods: Participants N = 94 were mother-infant pairs from the Chitwan district in Nepal. The neurodevelopment of the infants was assessed using the Brazelton Neonatal Behavioral Assessment Scale, Third Edition, NBAS III at birth and the Bayley Scales of Infant Development, Second Edition, BSID II at ages 6, 24, and 36 months. Caste was categorized based on surname, which, in Nepal generally refers to one of four caste groups. We also measured the concentrations of As and Pb in cord blood. Results: Caste was positively associated with the state regulation cluster score of the NBAS III at birth after adjustment for covariates p for trend 0.01. Adding cord blood As levels attenuated the association p for trend = 0.12. With regard to neurodevelopment at six months of age, the third-ranked caste group scored higher than the first-ranked caste group on the Mental Development Index MDI of the BSID II coefficient = 3.7; 95% confidence interval CI = 1.3 to 6.0. This difference remained significant after adjustment for cord blood As levels and other covariates was made coefficient = 3.9; 95% CI = 1.2 to 6.7. The remaining clusters of the NBAS III and BSID II at 6, 24, and 36 months were not significantly associated with caste group. Conclusions: Caste was positively associated with the state regulation cluster score of NBAS III at birth. This association was partially mediated by cord blood As levels. However, the negative impact of caste on neurodevelopment disappeared as the children grew. Furthermore, an inverse association between caste and MDI at six months of age was observed. Additional studies are needed to elucidate the mechanism of how caste affects neurodevelopment.



Author: Parajuli, Rajendra Prasad; Fujiwara, Takeo; Umezaki, Masahiro; Watanabe, Chiho

Source: https://archive.org/







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