Maternal immigrant status and signs of neurodevelopmental problems in early childhood: The French representative ELFE birth cohort

Abstract

A growing body of evidence suggests that children of immigrants may have increased risks of neurodevelopmental disorders. However, evidence based on parent report and on very young children is lacking. We therefore investigated the association between maternal immigrant status and early signs of neurodevelopmental problems in a population‐based sample of 2‐year‐old children using standardized parent‐report instruments. We used data from the French representative Étude Longitudinale Française depuis l'Enfance birth cohort, initiated in 2011. The study sample included 9,900 children of nonimmigrant French, 1,403 children of second, and 1,171 children of first generation immigrant women followed‐up to age 2 years. Neurodevelopment was assessed using the Modified Checklist for Autism in Toddlers (M‐CHAT) and an adaptation of the MacArthur‐Bates Communicative Development Inventories (MB‐CDI). In fully adjusted linear regression models, maternal immigrant status was associated with M‐CHAT scores, with stronger associations in children of first (β‐coefficient: 0.19; 95% CI 0.08–0.29) than second generation immigrants (0.09; 0.01–0.17). This association was especially strong among children of first generation immigrant mothers native of North Africa (vs. nonimmigrant French: 0.33; 0.16–0.49) and French‐speaking Sub‐Saharan Africa (0.26; 0.07–0.45). MB‐CDI scores were lowest among children of first generation immigrant mothers, particularly from mostly non‐francophone regions. Children of first generation immigrant mothers were most likely to have simultaneously low MB‐CDI and high M‐CHAT scores. Our findings suggest that maternal immigrant status is associated with early signs of neurodevelopmental difficulties, with strong variations according to maternal region of origin. Further research is necessary to test whether these associations persist and to determine the underlying mechanisms. Autism Res 2019, 12: 1845–1859. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary We asked immigrant and nonimmigrant mothers in France about early signs of neurodevelopmental problems in their 2‐year‐old children. Overall, we found that children of immigrants may be at higher risk of showing these early warning signs, as compared to children of nonimmigrants. This is in line with previous studies, which were based on doctors' diagnoses at later ages. However, our results differed depending on the mothers' regions of origin. We found the highest risks in children of first generation immigrants from North and French‐speaking Sub‐Saharan Africa, who also seemed especially at risk of neurodevelopmental problems combined with low language development.

Neurodesarrollo y estimulación oportuna en niños de madres indígenas migrantes y no migrantes en Chihuahua, México

“…In addition to the findings of our study, evidence from Australia, Europe, Africa and North America has indicated greater risks for neurodevelopment disorders in the children of immigrant parents (Abdullahi et al, 2018;Schmengler et al, 2019). This evidence confirms the declaration by the International Society for Social Pediatrics and Child Health (ISSOP-Migration Working Group, 2018) calling for greater knowledge generation and sharing about health, education and care access risks of children of migrant parents.…”

“…Evidence indicates that migration during childhood affects neurodevelopment. Schmengler et al (2019) demonstrated the importance of the timely detection of signs of neurological abnormalities in immigrant children two years of age, given the potential repercussions for age-appropriate development.…”

TV, computer, tablet and smartphone use and autism spectrum disorder risk in early childhood: a nationally-representative study

“…First, ELFE is based on parents’ voluntary participation and may have left out children vulnerable to neurodevelopmental difficulties [ 9 ]. Nevertheless, the sample is heterogeneous-enough to study environmental risk factors of neurodevelopment [ 12 , 15 ] and our data were weighted to be nationally representative. Second, ELFE is a longitudinal cohort study, but the data we used are cross-sectional and we cannot rule out that children’s neurodevelopmental difficulties could influence their screen use.…”

“…Because children who use screens and those who do not are likely to different with regard to many different characteristics, covariates were controlled for using propensity scores, which were calculated based on the variables listed below [ 12 ]: Family socio-demographic characteristics reported by the mother after delivery: maternal age (< 30 vs. ≥ 30 years – the average age at first childbirth for women), paternal age (< 30 vs. ≥ 30 years), maternal and paternal birth place (France vs. Other), mother’s educational level, number of children living in the household (1, 2–3, ≥ 4), maternal and paternal residential area (Greater Paris Region; Paris and suburbs, North-West, East, West, South-West, Centre-East, and South-East) and household income per capita assessed when the child was 2 years (divided into 3 categories based on the minimum wage, average wage and above average wage in 2013, https://www.insee.fr/fr/statistiques/1375188 ) (< 1,423; 1,423–1,996; > 1,996 euros/month). Maternal mental health reported by the mother when the child was 2 months old (Edinburgh Postnatal Depression Scale (EPDS) – a score of ≥ 12 being considered as indicative of possible depression, yes vs. no [ 13 ]).…”

Inégalités sociales de santé. État des lieux, principes pour l’action

“…Ces troubles résultent des difficultés rencontrées lors des phases de prémigration (expériences traumatisantes, persécutions, difficultés économiques), de périmigration (violences / discriminations, séparation et perte de réseaux sociaux), de postmigration (instabilité administrative, détention, difficultés socioéconomiques, (distance culturelle, exclusion sociale, stress) [21].…”