This cohort study investigates the association of gestational age at birth with suspected developmental coordination disorder in early childhood among children aged 3 to 5 years in China.
ObjectivesThis study aimed to explore the cognitive development of low-risk children during early childhood for early-term births at 37 and 38 weeks of gestation compared with full term births at 39–41 weeks of gestation.Setting and participantsWe conducted a cross-sectional study in Shanghai, one of the largest cities in China. A total of 1444 children from singleton pregnancies born at term gestation were included in the study.MeasuresThe cognitive outcomes of the subjects were measured using the cognitive subtest of Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) across three cities in China. We analysed the association between gestational age and cognitive development during infancy and toddler stages using multivariate linear modelling.ResultsThe cognitive development scores for infants born at 37 gestational weeks were significantly lower than those born at 39–41 gestational weeks (β=−2.257, 95% CI −4.280 to −0.235; p<0.05) after adjusting for children’s and maternal characteristics, as well as socio-economic factors. However, there were no significant differences in cognitive ability between infants born at 38 gestational weeks compared with their full-term counterparts (p>0.05). Moreover, these effects were not found in toddlers (between 17 and 48 months of age) after adjusting for the possible confounders (p>0.05).ConclusionsInfants born at 37 weeks of gestation exhibited weaker cognitive ability compared with those born at 39–41 weeks of gestation. Our findings provide evidences for the close monitoring of potential developmental problems in early-term children, especially those born at 37 gestational weeks.
IntroductionThe change in Chinese fertility policy brings new challenges and considerations for children’s health outcomes; however, very little is known about the interaction between siblings, family socioeconomic status (SES), and neurodevelopment in the Chinese preschool-age population. Therefore, this study aimed to develop a new explanatory pathway from sibling effect to early childhood development and explored the mediation effect of family SES in the pathway.MethodsFrom April 2018 to December 2019, we conducted a national retrospective cohort study in 551 cities in China, and a total of 115,915 preschool-aged children were selected for the final analysis. Children’s neurodevelopment, including Communication, Gross motor, Fine motor, Problem-solving, and Personal-social, was assessed with the Ages & Stages Questionnaires, Third Edition (ASQ-3). Hypothesis tests and multilevel regression models were used to assess the associations and their strength between sibling effect and neurodevelopmental delay. Pathway analysis was used to verify the mediation effect of SES.ResultsThe results showed that there were significant risk effects of a sibling on preschoolers’ overall neurodevelopment including communication, gross motor, fine motor, and problem-solving delay. The adjustment of family SES, however, brought a reversal of this association. The results of the mediation model illustrated a direct, protective effect of one-sibling status (βASQ-delay = −0.09; βASQ-scores = 0.07; p < 0.001), and an indirect, risk effect from one-sibling status through family SES to neurodevelopment outcomes (βASQ-delay =0.12; βASQ-scores = −0.12; p < 0.001). The total sibling effect was weakened but remained negative (βASQ-delay =0.03; βASQ-scores = −0.05; p < 0.001).DiscussionThis study concluded that family SES mediated the negative effects of one sibling on early child development. To enhance the positive influence of sibling addition, we suggested providing more resources and instructions to the families with less educated and poorer employed parents under the coming multi-child era.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.