Prevalence and determinants of developmental delay among children below two years of age visiting an immunization clinic of a tertiary care centre in South India

Background: Developmental delay in children is a worldwide public health problem. It can lead to significant motor and neurocognitive issues along with social constraints. Early detection and intervention are essential to optimize developmental outcomes for children with delays. This study aims to investigate the prevalence and determinants of developmental delay in children aged from two months to two years visiting the immunization clinic of Sree Avittam Thirunal hospital, Kerala, India, using the Trivandrum Developmental Screening Chart (TDSC). Methods: A hospital-based cross-sectional study was conducted among 300 children aged two months to two years visiting the immunization clinic. Socio-demographic, maternal obstetric, antenatal and neonatal data were collected from mothers/guardians using a semi-structured interviewer-administered questionnaire. TDSC was used for screening. Results were analyzed using SPSS v.27 and R studio v.2023.09.1+494 software. Results: Out of 300 children studied, 30(10%) were identified with developmental delay amongst which 43.3% had multiple item delay. On univariate analysis factors such as parents’ age and education, father’s occupation, antenatal history of decreased fetal movements, gestational age, history of feeding difficulty soon after birth, neonatal infections and birth weight were found to be significant. Multivariable analysis showed maternal education, gestational age at birth and neonatal infections to have a significant association with developmental delay. Conclusions: The observed prevalence of developmental delay was 10% (95% CI 6.8-14). The significant risk factors identified like maternal education, gestational age and neonatal infections offer insights for intervention. The study highlights the importance of integrating developmental screening into immunization clinics for early detection and intervention.