CLINICO-ETIOLOGICAL PROFILE OF CHILDREN PRESENTING WITH GLOBAL DEVELOPMENTAL DELAY IN A TEACHING HOSPITAL OF RAJASTHAN: AN OBSERVATIONAL STUDY

Dr. Utkarsh Sharma, Dr. Priya Marwah*, Dr. Rupesh Masand

ABSTRACT

Background: Global Developmental Delay (GDD) is one of the most common neurodevelopmental conditions encountered in paediatric practice, defined as significant delay in two or more developmental domains in children typically under the age of five years. The aim of this study was to determine the clinical and etiological profile of children presenting with GDD and to study associated co-morbidities such as convulsions, cerebral palsy and behaviour disorders. Methodology: A hospital-based observational study was conducted at the Department of Paediatrics, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, from April 2024 to September 2025. A total of 100 children aged 6 months to 5 years presenting with GDD were enrolled after obtaining informed parental consent. Developmental assessment was performed using the Trivandrum Developmental Screening Chart (TDSC) and children with a developmental quotient (DQ) less than 70% in two or more domains were included. Statistical analysis was performed using SPSS version 20.0; quantitative data were expressed as mean ± SD and qualitative data as percentages and proportions. Results: The majority of children belonged to the 3–4 years age group (50%) with a mean age of 3.647 ± 1.541 years. Male predominance was observed (77% males vs. 23þmales). Consanguinity was present in only 5% and positive family history in 7% of cases. The most common presenting symptom was isolated developmental delay (40%), followed by developmental delay with seizures (15%) and feeding problems (15%). On clinical examination, cerebral palsy was the most common CNS finding (20%), followed by microcephaly (15%). Most children had a DQ in the range of 21–30% (44%), reflecting moderate to severe developmental impairment. Perinatal asphyxia was the leading etiology (40%), followed by idiopathic causes (21%) and cortical dysgenesis (10%). Neuroimaging was abnormal in 28% and electrophysiological studies were abnormal in 54% (EEG 34%, BERA 20%). Anemia was the most common laboratory finding (30%). Neurological co-morbidities included sleep issues (30%), seizures (25%), cerebral palsy (20%) and feeding problems (20%). Non-neurological co-morbidities included anemia (30%), undernutrition (25%) and constipation (25%). Psychiatric/behavioral co-morbidities included mood disorders (15%), ADHD (10%) and autism (7%). Conclusion: Perinatal asphyxia is the predominant and largely preventable cause of GDD in this region. Most children presented late with moderate to severe developmental delay, underscoring the need for early developmental screening and timely referral. The high burden of nutritional co-morbidities, particularly anemia and undernutrition, highlights the importance of integrated maternal and child health programmes. Improved antenatal and perinatal care, neonatal resuscitation services and early multidisciplinary intervention are essential to reduce the burden of GDD.

Keywords:

Global Developmental Delay, Perinatal Asphyxia, Developmental Quotient, Clinico-etiological Profile, Cerebral Palsy, Rajasthan

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