Neurodevelopmental, cognitive, behavioural and mental health impairments following childhood malnutrition: a systematic review.
Neurodevelopmental, cognitive, behavioural and mental health impairments following childhood malnutrition: a systematic review.
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儿童营养不良后的神经发育、认知、行为和心理健康损害：一项系统综述。
DOI：
10.1136/bmjgh-2022-009330
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发表时间：
2022-07
影响因子：
8.1
通讯作者：
Kerac, Marko
中科院分区：
文献类型：
--
作者：
Kirolos, Amir;Goyheneix, Magdalena;Eliasz, Mike Kalmus;Chisala, Mphatso;Lissauer, Samantha;Gladstone, Melissa;Kerac, Marko
关键词：
儿童期严重营养不良会在短期内损害生长和发育，但目前对长期结果的了解有限。我们的目的是确定评估儿童营养不良后神经发育，认知，行为和心理健康结果的研究。我们系统地检索了MEDLINE、EMBASE、Global Health和PsycINFO，以寻找评估低收入和中等收入环境中儿童营养不良者的这些结果的研究。我们纳入了评估营养不良的研究，这些研究通过低中上臂围、身高别体重、年龄别体重或营养性水肿来衡量。我们使用不含荟萃分析的结果综合指南来分析三个结果领域：神经发育、认知/学业成绩、行为/心理健康。我们确定了30项研究，包括一些长期的队列报告结果，直到成年。基于使用经过验证的神经发育评估工具进行的高质量研究，有强有力的证据表明儿童期营养不良会对神经发育产生负面影响。也有强有力的证据表明，营养不良会损害学业成绩，七项研究调查了这一结果。11项研究中有8项表明儿童营养不良与认知受损之间存在关联。由于一些研究未能衡量社会经济地位等重要混杂因素，这种温和的证据受到限制。7项研究中有5项发现，与对照组相比，儿童期营养不良者的行为评估评分存在差异，但这一温和的证据同样受到未测量混杂因素的限制。心理健康的影响难以确定，因为很少有研究结果不一。儿童营养不良与神经发育受损、学业成绩、认知和行为问题有关，但关于可能的心理健康影响的证据尚不确定。未来的研究应该探讨童年和晚年逆境对这些结果的相互作用。虽然还需要改善营养和临床治疗以减少长期风险的证据，但预防和消除儿童营养不良可能是预防长期神经认知损害的最佳方法。CRD 42021260498。
Severe childhood malnutrition impairs growth and development short-term, but current understanding of long-term outcomes is limited. We aimed to identify studies assessing neurodevelopmental, cognitive, behavioural and mental health outcomes following childhood malnutrition. We systematically searched MEDLINE, EMBASE, Global Health and PsycINFO for studies assessing these outcomes in those exposed to childhood malnutrition in low-income and middle-income settings. We included studies assessing undernutrition measured by low mid-upper arm circumference, weight-for-height, weight-for-age or nutritional oedema. We used guidelines for synthesis of results without meta-analysis to analyse three outcome areas: neurodevelopment, cognition/academic achievement, behaviour/mental health. We identified 30 studies, including some long-term cohorts reporting outcomes through to adulthood. There is strong evidence that malnutrition in childhood negatively impacts neurodevelopment based on high-quality studies using validated neurodevelopmental assessment tools. There is also strong evidence that malnutrition impairs academic achievement with agreement across seven studies investigating this outcome. Eight of 11 studies showed an association between childhood malnutrition and impaired cognition. This moderate evidence is limited by some studies failing to measure important confounders such as socioeconomic status. Five of 7 studies found a difference in behavioural assessment scores in those exposed to childhood malnutrition compared with controls but this moderate evidence is similarly limited by unmeasured confounders. Mental health impacts were difficult to ascertain due to few studies with mixed results. Childhood malnutrition is associated with impaired neurodevelopment, academic achievement, cognition and behavioural problems but evidence regarding possible mental health impacts is inconclusive. Future research should explore the interplay of childhood and later-life adversities on these outcomes. While evidence on improving nutritional and clinical therapies to reduce long-term risks is also needed, preventing and eliminating child malnutrition is likely to be the best way of preventing long-term neurocognitive harms. CRD42021260498.
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影响因子：
5.9
作者：
Chen K;Liu C;Liu X;Wang Z;Luo R;Li S;Yu Y;Alderman H
通讯作者：
Alderman H
影响因子：
2.4
作者：
Abessa TG;Bruckers L;Kolsteren P;Granitzer M
通讯作者：
Granitzer M
影响因子：
3.4
作者：
Kang, Yunhee;Aguayo, Victor M.;West, Keith P., Jr.
通讯作者：
West, Keith P., Jr.
影响因子：
8.1
作者：
Grey K;Gonzales GB;Abera M;Lelijveld N;Thompson D;Berhane M;Abdissa A;Girma T;Kerac M
通讯作者：
Kerac M
DOI：
10.1038/nrdp.2017.67
发表时间：
2017-09-21
期刊：
Nature reviews. Disease primers
影响因子：
--
作者：
Bhutta ZA;Berkley JA;Bandsma RHJ;Kerac M;Trehan I;Briend A
通讯作者：
Briend A