MICRONUTRIENT DEFICIENCIES AND NEURODEVELOPMENTAL DELAYS IN TODDLERS: A CROSS-SECTIONAL STUDY

Background: Micronutrient deficiencies, particularly iron, vitamin B12, and zinc, are prevalent among children under five and are linked to impaired neurodevelopment. Despite their significance, few studies have jointly evaluated these deficiencies in relation to developmental outcomes using standardized tools. Objective: To determine the prevalence of iron, vitamin B12, and zinc deficiencies and assess their association with neurodevelopmental delays in children aged 12–59 months. Methods: A cross-sectional study was conducted over eight months in tertiary care hospitals in Islamabad and Rawalpindi. A total of 320 children were enrolled based on predefined inclusion criteria. Blood samples were analyzed for serum ferritin, vitamin B12, and zinc levels. Neurodevelopment was assessed using the Ages and Stages Questionnaire, Third Edition (ASQ-3), across five developmental domains. Statistical analyses included chi-square tests, t-tests, and multivariate logistic regression to identify associations between deficiencies and developmental delays, adjusting for confounders. Results: Iron, vitamin B12, and zinc deficiencies were found in 26.3%, 20.6%, and 22.2% of participants, respectively. Developmental delays were most frequent in the fine motor (14.7%) and communication (12.8%) domains. Logistic regression analysis revealed significant associations between micronutrient deficiencies and developmental delays: iron (AOR = 2.31, 95% CI: 1.44–3.72), vitamin B12 (AOR = 1.89, 95% CI: 1.13–3.18), and zinc (AOR = 2.05, 95% CI: 1.25–3.36). Conclusion: Micronutrient deficiencies, particularly of iron, vitamin B12, and zinc, are significantly associated with neurodevelopmental delays in young children. Routine nutritional screening and early interventions are critical to support optimal child development.