Risk factors for suspected developmental delay at age 2 years in a Brazilian birth cohort

Abstract

de Moura DR, Costa JC, Santos IS, Barros AJD, Matijasevich A, Halpern R, Dumith S, Karam S, Barros FC. Risk factors for suspected developmental delay at age 2 years in a Brazilian birth cohort. Paediatric and Perinatal Epidemiology 2010; 24: 211–221.Many children are at risk of not achieving their full potential for development. Epidemiological studies have the advantage of being able to identify a number of associated factors potentially amenable to intervention. Our purpose was to identify risk factors for suspected developmental delay (SDD) at age 2 years among all children born in the city of Pelotas, Brazil, in 2004. This study was part of the 2004 Pelotas Birth Cohort. The Battelle Screening Developmental Inventory (BSDI) was administered to cohort children at age 2 years. A hierarchical model of determination for SDD with confounder adjustment was built including maternal sociodemographic, reproductive and gestational characteristics, as well as child and environmental characteristics. Multivariable analysis was carried out using Poisson regression. Prevalence ratios (PR) and 95% confidence intervals [95% CI] were calculated.In the results, 3.3% of the 3869 children studied screened positive for SDD. After confounder control, children more likely to show SDD were: those with positive BSDI at age 12 months (PR = 5.51 [3.59, 8.47]); with 5-min Apgar <7 (PR = 3.52 [1.70, 7.27]); with mothers who had <4 years of schooling (PR = 3.35 [1.98, 5.66]); from social classes D and E (PR = 3.00 [1.45, 6.19]); with a history of gestational diabetes (PR = 2.77 [1.34, 5.75]); born <24 months after the last sibling (PR = 2.46 [1.42, 4.27]); were not told child stories in the preceding week (PR 2.28 [1.43, 3.63]); did not have children's literature at home (PR = 2.08 [1.27, 3.39]); with low birthweight (PR = 1.75 [1.00, 3.07]); were born preterm (PR = 1.74 [1.07, 2.81]); with <6 antenatal care appointments (PR = 1.70 [1.07, 2.68]); with history of hospitalisation (PR = 1.65 [1.09, 2.50]); and of male sex (PR = 1.43 [1.00, 2.04]). These risk factors may constitute potential targets for intervention by public policies and may provide help to paediatricians in preventing developmental delay.

Birth Spacing and Risk of Autism and Other Neurodevelopmental Disabilities: A Systematic Review

“…A total of 12 studies (6 cohort, 5 cross-sectional, and 1 case-control), including 1 334 569 children, met the inclusion criteria. [28][29][30][31][32][33][34][35][36][37][38][39] The individual characteristics and main findings of the studies included in the systematic review are shown in Table 1. Seven studies provided data on ASD, 28 …”

“…[35][36][37] A large population-based study from the United States (N = 170 874) 35 found that short IPIs were associated with significantly increased risk of developmental delay or disability in the first 3 years of life. The risk of developmental delay decreased significantly for each 1-month increase in IPI since the birth of the previous sibling up to 60 months (OR for each 1-month increase in IPI 0.995, 95% CI 0.993-0.997).…”

“…The risk of developmental delay decreased significantly for each 1-month increase in IPI since the birth of the previous sibling up to 60 months (OR for each 1-month increase in IPI 0.995, 95% CI 0.993-0.997). Two studies conducted in Brazil assessed the association between birth interval and suspected developmental delay at age 2 years 37 or up to age 6 years. 36 Both studies found that short birth intervals (<19 months 36 and <24 months 37 ) were associated with a significantly higher risk of suspected developmental delay (adjusted OR 3.90, 95% CI 1.02-24.08 36 ; adjusted RR 1.91, 95% CI 1.73-2.09 37 ).…”

O contexto ambiental e o desenvolvimento na primeira infância: estudos brasileiros

“…Other studies 8,21,[23][24][25][26][27][28]29 investigated the relationship between the risk factors existing in the home environment and child development. These studies, in most cases, found a relationship between the children's poor performance in tests and the following risk factors: low maternal schooling 8,[25][26][27][28] ; the mother having done less than six antenatal consultations [25][26]29 ; unemployed parent 27 ; belonging to the lower strata of the economic classification 8,[25][26][27][28][29] ; having a mother who does not work outside the home 8 ; father's low schooling 24 ; having many siblings 28 ; less support from parents in caring for the child 28 and lower psychosocial stimulation in the home environment [25][26] .…”

Developmental delay in early childhood is associated with visual-constructive skills at school age in a Brazilian cohort

“…It was estimated that about 200 million children (up to 5 years old) across the world present delays in their development (Grantham-McGregor et al, 2007). In Brazil, it was reported that 3.3 % of the 3869 two-year-old children screened positive for suspected developmental delay (de Moura et al, 2010). Longitudinal studies have reported the relationship between neuropsychomotor delays and deficits on intelligence (Davis et al 2007;Murray et al 2007), language (Amaral et al 2005), academic achievement (Taanila et al 2005), and socioemotional skills (Bart et al 2007).…”