{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:04:21Z","timestamp":1792425861095,"version":"4.5.0"},"reference-count":61,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T00:00:00Z","timestamp":1655769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NGO Un Kilo de Ayuda A.C., Mexico (UKA), Promotora Social Mexico and Nacional Monte de Piedad","award":["1538\/CI-896-2018\/CB18-317"],"award-info":[{"award-number":["1538\/CI-896-2018\/CB18-317"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Early childhood development (ECD) is a critical stage in the intergenerational process of human development. Targeted interventions depend on accurate and up-to-date ECD measurements. This paper presents estimates for the nutritional and neurodevelopmental status of socially marginalized children in Mexico. We performed a cross-sectional study based on data collected in 2019\u20132020 during home visits to 1,176 children aged 0\u201338 months across 24 highly marginalized locations in Oaxaca. We assessed nutritional status according to the World Health Organization 2006 child-growth standards and ECD status using the Child Development Evaluation Test, 2<jats:sup>nd<\/jats:sup>Edition. We stratified results by sex. Prevalence of stunting was 5.3 percentage points (p.p.) higher (<jats:italic>p<\/jats:italic>= 0.023) in males (25.3%; 95% CI: 20.2%, 31.1%) compared to females (20.0%; 95% CI: 15.0%, 26.1%). Overall prevalence rates stood at 5.7% (95% CI: 4.0%, 8.1%) for underweight, 1.5% (95% CI: 0.9%, 2.7%) for wasting and 3.6% (95% CI: 2.3%, 5.7%) for overweight\/obesity, with no significant differences by sex. Prevalence of normal development was 8.3 p.p. lower (<jats:italic>p<\/jats:italic>= 0.001) in males (39.3%; 95% CI: 34.5%, 44.4%) compared to females (47.6%; 95% CI: 41.6%, 53.6%). By development area, the highest prevalence of suboptimal outcomes among children with developmental lag or at risk of delay was observed in their gross motor and language skills: 24.1% (95% CI: 20.0%, 28.8%) and 38.6% (95% CI: 34.0%, 43.3%), respectively. The largest difference between the sexes was found in the language area. Our results show that childhood development strategies have been insufficient thus far in the studied population. Programs specifically designed to prevent ECD lags and bridge inequality gaps are urgently needed.<\/jats:p><jats:p><jats:bold>Trial registration:<\/jats:bold>ClinicalTrials.gov ID:<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04210362\" xlink:type=\"simple\">NCT04210362<\/jats:ext-link>.<\/jats:p>","DOI":"10.1371\/journal.pone.0270085","type":"journal-article","created":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T17:31:11Z","timestamp":1655832671000},"page":"e0270085","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Early neurological development and nutritional status in Mexican socially deprived contexts"],"prefix":"10.1371","volume":"17","author":[{"given":"Edson","family":"Serv\u00e1n-Mori","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5551-6133","authenticated-orcid":true,"given":"Evelyn","family":"Fuentes-Rivera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amado D.","family":"Quezada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Pineda-Antunez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"del Carmen Hern\u00e1ndez-Ch\u00e1vez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ang\u00e9lica","family":"Garc\u00eda-Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby","family":"Madrigal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7370-2335","authenticated-orcid":true,"given":"Raquel","family":"Garc\u00eda-Feregrino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Santiago-Angelino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Hern\u00e1ndez-Serrato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lourdes","family":"Schnaas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,6,21]]},"reference":[{"key":"pone.0270085.ref001","first-page":"1","volume-title":"From early child development to human development: Investing in our children\u2019s future","author":"The World Bank (WB)","year":"2002","edition":"1"},{"issue":"10064","key":"pone.0270085.ref002","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S0140-6736(16)31389-7","article-title":"Early childhood development coming of age: Science through the life course","volume":"389","author":"MM Black","year":"2017","journal-title":"Lancet"},{"key":"pone.0270085.ref003","unstructured":"National Scientific Council on the Developing Child. The science of early childhood development: Closing the gap between what we know and what we do. Boston, MA; 2007."},{"issue":"10064","key":"pone.0270085.ref004","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/S0140-6736(16)31698-1","article-title":"Investing in the foundation of sustainable development: Pathways to scale up for early childhood development","volume":"389","author":"LM Richter","year":"2017","journal-title":"Lancet"},{"key":"pone.0270085.ref005","author":"MC Araujo","year":"2015","journal-title":"The early years: Child well-being and the role of public policy"},{"key":"pone.0270085.ref006","author":"United Nations International Children\u2019s Emergency Fund (UNICEF)","year":"2015","journal-title":"For every child, a fair chance: The promise of equity. New York, NY 10017, USA"},{"issue":"9799","key":"pone.0270085.ref007","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1016\/S0140-6736(11)60889-1","article-title":"Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries","volume":"378","author":"PL Engle","year":"2011","journal-title":"Lancet"},{"key":"pone.0270085.ref008","article-title":"Psychometric characteristics of cognitive development and achievement instruments in round 2 of young lives","author":"S Cueto","year":"2009","journal-title":"Oxford"},{"key":"pone.0270085.ref009","first-page":"1","volume-title":"Parental priorities and economic inequality","author":"CB Mulligan","year":"1997","edition":"2"},{"issue":"1","key":"pone.0270085.ref010","first-page":"129","article-title":"Habilidades cognitivas: Transmisi\u00f3n intergeneracional por niveles socioecon\u00f3micos","volume":"23","author":"D Mayer-Foulkes","year":"2008","journal-title":"Estud Econ\u00f3micos"},{"key":"pone.0270085.ref011","article-title":"Sustainable Development Goals","author":"United Nations Development Programme (UNDP)","year":"2022","journal-title":"About the Sustainable Development Goals"},{"key":"pone.0270085.ref012","article-title":"Extreme inequality in Mexico","author":"G. 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Estrategia nacional de atenci\u00f3n a la primera infancia (ENAPI) [Internet]. Ciudad de M\u00e9xico, M\u00e9xico; 2020. 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Oaxaca"},{"key":"pone.0270085.ref020","author":"Instituto Nacional de Estad\u00edstica, Geograf\u00eda e Inform\u00e1tica (INEGI)","year":"2020","journal-title":"Poblaci\u00f3n total por entidad federativa y grupo quinquenal de edad seg\u00fan sexo, serie de a\u00f1os censales de 1990 a 2020"},{"key":"pone.0270085.ref021","article-title":"Resultados del \u00cdndice de Rezago Social (IRS) 2020 para Oaxaca","author":"Coordinaci\u00f3n de Planeaci\u00f3n y Evaluaci\u00f3n para el Desarrollo Social (COPEVAL) de Oaxaca","year":"2021","journal-title":"Oaxaca de Ju\u00e1rez"},{"key":"pone.0270085.ref022","author":"Instituto Nacional de Estad\u00edstica, Geograf\u00eda e Inform\u00e1tica (INEGI)","year":"2020","journal-title":"Informaci\u00f3n por entidad. Diversidad"},{"key":"pone.0270085.ref023","author":"Consejo Nacional de Poblaci\u00f3n (CONAPO)","year":"2015","journal-title":"\u00cdndice de marginaci\u00f3n por entidad federativa y municipio 2015"},{"key":"pone.0270085.ref024","article-title":"Metodolog\u00eda para la medici\u00f3n multidimensional de la pobreza en M\u00e9xico","author":"Consejo Nacional de Evaluaci\u00f3n de la Pol\u00edtica de Desarrollo Social (CONEVAL)","year":"2019","journal-title":"Tercera ed. Ciudad de M\u00e9xico: CONEVAL"},{"issue":"126","key":"pone.0270085.ref025","first-page":"1","article-title":"Assessing the effect of an educational intervention on early childhood development among Mexican preschool children in the state of Oaxaca: a study protocol of a cluster randomized stepped-wedge trial","volume":"23","author":"A Quezada-S\u00e1nchez","year":"2022","journal-title":"BMC Trials"},{"issue":"1","key":"pone.0270085.ref026","first-page":"1","article-title":"Research electronic Data Capture (RedCap)","volume":"106","author":"P. Harris","year":"2018","journal-title":"J Med Libr Assoc"},{"key":"pone.0270085.ref027","first-page":"1","volume-title":"Anthropometric standarization reference manual","author":"T Lohman","year":"1988","edition":"1"},{"issue":"5","key":"pone.0270085.ref028","first-page":"375","article-title":"Standardization of anthropometric methods in the field","volume":"76","author":"J. Habicht","year":"1974","journal-title":"PAHO Bull"},{"key":"pone.0270085.ref029","volume-title":"WHO Child Growth Standards: Length\/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development","author":"World Health Organization (WHO) Multicentre Growth Reference Study Group","year":"2006"},{"key":"pone.0270085.ref030","volume-title":"WHO Expert Committee on Physical Status: The use and interpretation of anthropometry. WHO technical report series 845","author":"World Health Organization (WHO)","year":"1995"},{"key":"pone.0270085.ref031","article-title":"Evaluaci\u00f3n de desarrollo infantil prueba EDI 2a edici\u00f3n manual de aplicaci\u00f3n","author":"Comisi\u00f3n Nacional de Protecci\u00f3n Social en Salud (CNPSS)","year":"2016","journal-title":"Ciudad de M\u00e9xico: Secretaria de Salud"},{"key":"pone.0270085.ref032","article-title":"Manual para la aplicaci\u00f3n de la prueba de evaluaci\u00f3n del desarrollo infantil (EDI)","author":"Centro Nacional para la Salud de la Infancia y la Adolescencia (CeNSIA)","year":"2021","journal-title":"Ciudad de M\u00e9xico, M\u00e9xico"},{"issue":"3","key":"pone.0270085.ref033","first-page":"195","article-title":"Validaci\u00f3n de un instrumento para la detecci\u00f3n oportuna de problemas de desarrollo en menores de 5 a\u00f1os en M\u00e9xico","volume":"70","author":"A Rizzoli-Cordoba","year":"2013","journal-title":"Bol Med Hosp Infant Mex"},{"key":"pone.0270085.ref034","first-page":"1","article-title":"Indicadores de la Poblaci\u00f3n Ind\u00edgena","author":"Instituto Nacional de los Pueblos Ind\u00edgenas (INPI)","year":"2015","journal-title":"Documentos"},{"key":"pone.0270085.ref035","volume-title":"\u00cdndice de marginaci\u00f3n por localidad 2010","author":"Consejo Nacional de Poblaci\u00f3n (CONAPO)","year":"2012","edition":"1"},{"issue":"13","key":"pone.0270085.ref036","first-page":"1","article-title":"Regression standard errors in clustered samples","volume":"3","author":"W. Rogers","year":"1994","journal-title":"Stata Tech Bull"},{"key":"pone.0270085.ref037","volume-title":"Stata Statistical Software: Release 17 MP","author":"StataCorp","year":"2021"},{"issue":"4","key":"pone.0270085.ref038","doi-asserted-by":"crossref","first-page":"e004436","DOI":"10.1136\/bmjgh-2020-004436","article-title":"The principles of Nurturing Care promote human capital and mitigate adversities from preconception through adolescence","volume":"6","author":"MM Black","year":"2021","journal-title":"BMJ Glob Heal"},{"issue":"2","key":"pone.0270085.ref039","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1093\/ajcn\/nqaa171","article-title":"COVID-19 pandemic and mitigation strategies: Implications for maternal and child health and nutrition","volume":"112","author":"N Akseer","year":"2020","journal-title":"Am J Clin Nutr"},{"issue":"10282","key":"pone.0270085.ref040","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1016\/S0140-6736(21)00394-9","article-title":"Revisiting maternal and child undernutrition in low-income and middle-income countries: variable progress towards an unfinished agenda","volume":"397","author":"CG Victora","year":"2021","journal-title":"Lancet"},{"issue":"10250","key":"pone.0270085.ref041","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/S0140-6736(20)31647-0","article-title":"Impacts of COVID-19 on childhood malnutrition and nutrition-related mortality","volume":"396","author":"D Headey","year":"2020","journal-title":"Lancet"},{"issue":"1","key":"pone.0270085.ref042","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s12939-021-01390-w","article-title":"A hidden side of the COVID-19 pandemic in children: The double burden of undernutrition and overnutrition","volume":"20","author":"B Zemrani","year":"2021","journal-title":"Int J Equity Health"},{"issue":"5","key":"pone.0270085.ref043","first-page":"569","article-title":"Monitoring indicators of the program \u201cChile Grows with You\u201d 2008\u20132011","volume":"85","author":"E Atalah","year":"2014","journal-title":"Rev Chil pediatr\u00eda"},{"key":"pone.0270085.ref044","article-title":"II Encuesta de Calidad de Vida y Salud Chile 2006. Resultados regionales y por zona rural y urbana","author":"Ministerio de Salud","year":"2006","journal-title":"Santiago de Chile, Chile"},{"issue":"6","key":"pone.0270085.ref045","doi-asserted-by":"crossref","first-page":"775","DOI":"10.21149\/10560","article-title":"Contexto y resultados del desarrollo infantil temprano en ni\u00f1os y ni\u00f1as de 12 a 59 meses en M\u00e9xico","volume":"61","author":"F De Castro","year":"2019","journal-title":"Salud Publica Mex"},{"issue":"6","key":"pone.0270085.ref046","first-page":"397","article-title":"Diagnostic evaluation of the developmental level in children identified at risk of delay through the child development evaluation test","volume":"72","author":"A Rizzoli-Cordoba","year":"2015","journal-title":"Bol Med Hosp Infant Mex"},{"key":"pone.0270085.ref047","volume-title":"Resultados Nacionales","author":"T Shamah-Levy","year":"2020"},{"issue":"6","key":"pone.0270085.ref048","first-page":"409","article-title":"Escrutinio poblacional del nivel de desarrollo infantil en menores de 5 a\u00f1os beneficiarios de PROSPERA en M\u00e9xico","volume":"72","author":"A Rizzoli-C\u00f3rdoba","year":"2015","journal-title":"Bol Med Hosp Infant Mex"},{"issue":"12","key":"pone.0270085.ref049","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1016\/j.puhe.2015.07.036","article-title":"High prevalence of developmental delay among children under three years of age in poverty-stricken areas of China","volume":"129","author":"QW Wei","year":"2015","journal-title":"Public Health"},{"key":"pone.0270085.ref050","article-title":"Encuesta Nacional de Hogares (ENH). Principales resultados 2017","author":"Instituto Nacional de Estad\u00edstica, Geograf\u00eda e Inform\u00e1tica (INEGI)","year":"2017"},{"key":"pone.0270085.ref051","volume-title":"Diagn\u00f3stico y recomendaciones","author":"R Myers","year":"2013"},{"issue":"6","key":"pone.0270085.ref052","doi-asserted-by":"crossref","first-page":"833","DOI":"10.21149\/10642","article-title":"Desnutrici\u00f3n cr\u00f3nica en poblaci\u00f3n infantil de localidades con menos de 100 000 habitantes en M\u00e9xico","volume":"61","author":"L Cuevas-Nasu","year":"2019","journal-title":"Salud Publica Mex"},{"key":"pone.0270085.ref053","author":"Consejo Nacional de Evaluaci\u00f3n de la Pol\u00edtica de Desarrollo Social (CONEVAL)","year":"2018","journal-title":"Estudio diagn\u00f3stico del derecho a la alimentaci\u00f3n nutritiva y de calidad 2018"},{"key":"pone.0270085.ref054","first-page":"1","article-title":"Infant and young child feeding","author":"World Health Organization (WHO)","year":"2021","journal-title":"Fact sheets"},{"issue":"1","key":"pone.0270085.ref055","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1002\/imhj.21616","article-title":"All our sons: The developmental neurology and neuroendocrinology of boys at risk","volume":"38","author":"AN Schore","year":"2017","journal-title":"Infant Ment Heal J"},{"issue":"Octobe 2018","key":"pone.0270085.ref056","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.euroecorev.2018.06.009","article-title":"Gender differences in the benefits of an influential early childhood program","volume":"109","author":"JL Garc\u00eda","year":"2018","journal-title":"Eur Econ Rev"},{"key":"pone.0270085.ref057","author":"Naciones Unidas","year":"1948","journal-title":"La Declaraci\u00f3n Universal de Derechos Humanos"},{"issue":"2","key":"pone.0270085.ref058","first-page":"86","article-title":"Advances in early childhood development: From neurons to big scale programs","volume":"74","author":"R Perez-Escamilla","year":"2017","journal-title":"Bol Med Hosp Infant Mex"},{"issue":"10224","key":"pone.0270085.ref059","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/S0140-6736(19)32540-1","article-title":"A future for the world\u2019s children? 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