Front Pediatr. 2026 Aug 18;14:1893524. doi: 10.3389/fped.2026.1893524. eCollection 2026.
ABSTRACT
BACKGROUND: Moderate anthropometric undernutrition is associated with developmental risks, but the emotional, behavioral, and functional profiles of children with moderate anthropometric undernutrition managed in outpatient primary care follow-up remain insufficiently characterized.
METHODS: This cross-sectional case-control study examined 60 mother-child dyads in Adana, Türkiye (undernutrition, n = 30; control, n = 30). Children were assessed by age group using the Child Behavior Checklist, and mothers completed parent-proxy measures of quality of life, psychological distress, and parenting-related emotion regulation.
RESULTS: No statistically significant between-group differences were detected in the measured sociodemographic and general clinical variables, although the sample was not powered to establish equivalence or exclude residual confounding. Children with moderate anthropometric undernutrition were more often described as eating less or showing selective eating, and family relationship quality was less often rated as good. Parent-proxy quality of life, maternal psychological distress, and parenting-related emotion regulation did not differ at the group level. Preschool CBCL scores were comparable. In the CBCL/6-18 subgroup, primary comparisons using age- and sex-normed T-scores identified higher Somatic Complaints, Anxious/Depressed, Social Problems, Attention Problems, Internalizing Problems, and Total Problems scores in the undernutrition group. Somatic Complaints (q = 0.020), Attention Problems (q = 0.036), Anxious/Depressed (q = 0.047), and Internalizing Problems (q = 0.047) remained significant after false-discovery-rate correction; Social Problems and Total Problems did not survive correction and are interpreted as preliminary. Externalizing Problems were not elevated at the group level. Within the undernutrition group, higher internalizing and externalizing T-scores were associated with poorer parent-proxy quality of life in the primary Pearson analyses, although these associations were attenuated and did not survive correction in the all-Spearman sensitivity analysis.
CONCLUSION: Because of the cross-sectional design, the direction of these associations cannot be established; they may reflect nutritional influences on psychosocial functioning, behavioral or feeding difficulties contributing to low weight, or shared antecedents of both. These findings suggest a selective school-age psychosocial screening signal, rather than generalized impairment, in outpatient moderate anthropometric undernutrition. Routine nutrition follow-up may benefit from brief behavioral screening, feeding behavior assessment, and family-sensitive primary care support.
PMID:42682571 | PMC:PMC13529972 | DOI:10.3389/fped.2026.1893524
