Effect of nutritional rickets on the gross motor development of infants

To verify the role of rickets as a cause contributing to delays in the gross motor development of Infants, Design: Case-Control Study. Setting: The study was conducted in Al-Khansa Maternity and Children's Teaching Hospital in Mosul during the period from October 1997 to September 1998. Subjects: Fifty-nine infants under the age of 2 years with rickets who attended the out-patient clinic were studied Fifty-five non rachitic sex and age matched infants were selected as controls Data on the age, sex, feeding patterns, clinical presentations and gross motor developmental assessments were evaluated. The ages of all rachitic cases were under 2 years. No sex difference was found among rachitic Infants. Most of the cases [81.3%] were exclusively breast-fed, [13.5%] were on mixed diet and [5.1%] of the cases were bottle-fed. The most common clinical presentations were bronchopneumonia [22%] and gastroenteritis [20%]. More than half of the rachitic cases [54.2%] were delayed in their gross motor development while only [5.4%] of the controls were delayed. Males showed more delay than females [P< 0.01] with a sex ratio of 1.6:1 Rickets may be an important cause for delayed gross motor development in Infants

Stature and head size of childern with nutritional rickets

To measure the strength of association of nutritional rickets with short stature and head enlargement in children. Design: Case-control study. Setting: Al-Khansa Maternity and Children's Teaching Hospital in Mosul, during the period from June to December 1998. Participants: Seventy-one children under the age of 2 years with rickets who attended the out-patients clinic formed the cases. Sixty-two age- and sex-matched children attending the same clinic due to minor illnesses but without clinical evidences of rickets were selected as controls. Main outcome measures: Data on: feeding patterns, clinical signs of rickets are collected. Supine lengths and head circumferences of the cases of rickets and controls were compared in order to measure the strength of association of exposure to rickets with the short stature and the head enlargement. Majority of rachitic cases [73.2%] were exclusively breast-fed. The commonest clinical signs of rickets were: rachitic rosary, wrist widening and frontal bossing of the head. Strong association between nutritional rickets and short stature was observed [RR: 6.2, patients P < 0.001, 95% CI 2.5-13.9]. No such association was proved between nutritional rickets and head enlargement [RR: 1.1, patients: P- NS, 95% CI 0.3-4.3]. Nutritional rickets is strongly associated with short stature, but not with head entargement