Associations of vitamin D status, bone health and anthropometry, with gross motor development and performance of school-aged Indian children who were born at term with low birth weight

Abstract

ObjectivesThere is little information regarding motor development of children born at term with low birth weight (LBW), a group that constitutes a large proportion of children in South Asia. We used data from infancy and at school age from a LBW cohort to investigate children's motor performance using causal inference.DesignCross-sectional follow-up study.SettingDelhi, India.ParticipantsWe recruited 912 children aged 5 years who had participated in a trial of vitamin D for term LBW infants in the first 6 months of life.Outcome measuresWe focused on gross motor development, using the Ages and Stages Questionnaire (ASQ) gross motor scale and several measures of motor performance. We examined the effects on these of current anthropometry, vitamin D status and bone health, controlling for age, sex, season of interview, socioeconomic variables, early growth, recent morbidity, sun exposure and animal food intake.ResultsIn adjusted analyses, stunted children (height-for-age Z (HAZ) <−2) took longer to run 20 m (0.52 s, 95% CI 0.35 to 0.70; p<0.001) and had greater odds of a failing score on the ASQ (OR 3.00, 95% CI 1.41 to 6.38, p=0.004). Greater arm muscle area was associated with faster run time, and the ability to perform more stands and squats in 15 s. Poorer vitamin D status was associated with the ability to perform more stands and squats. Lower tibia ultrasound Z score was associated with greater hand grip strength. Early growth and current body mass index had no associations with motor outcomes.ConclusionsCurrent HAZ and arm muscle area showed the strongest associations with gross motor outcomes, likely due to a combination of simple physics and factors associated with stunting. The counterintuitive inverse associations of tibia health and vitamin D status with outcomes may require further research.

Vitamin D status in early childhood is not associated with cognitive development and linear growth at 6–9 years of age in North Indian children: a cohort study

“…The findings from this study are in accordance with findings from the same cohort when neurodevelopment was measured in early childhood [13]. The findings are also similar to those from a cohort study in India, where vitamin D status in early childhood was not associated with the gross motor functioning among school aged children [36]. Studies that have examined the association between cord blood vitamin D concentrations and neurodevelopment measured in early and middle childhood have shown mixed results [37,38].…”

Mechanical factors and vitamin D deficiency in schoolchildren with low back pain: biochemical and cross-sectional survey analysis

“…This correlation was confirmed with previous studies that reported that the deficiency in vitamin D may be related to poor PA,30 adiposity, minimal sun exposure,31–33 and insufficient dietary intake or impairments in metabolic activation of the vitamin 34–37. In addition, vitamin 25(OH) D deficiency was significantly reported in healthy growing children and adolescents in many countries,46–116 and it was significantly correlated with higher levels of serum sBAP, which may contribute to both optimizing bone mass and muscle strength 117…”

Association of maternal vitamin D deficiency and infants' neurodevelopmental status: A cohort study on vitamin D and its impact during pregnancy and childhood in Indonesia

“…Vitamin D plays a role in calcium and phosphorus metabolism, thus contributing to bone growth and reorganisation. In addition, vitamin D plays a role in reducing oxidative stress, antimicrobial defence, immunoregulation, anti‐inflammation, anticancer properties, neuroprotective factors and child development …”