Features and Associated Factors of the Behavioral Development of 24-month-old Children in Rural China: Follow-up Evaluation of a Randomized Controlled Trial

Xue Yang,Zhaoyang Yin,Zhonghai Zhu,Danyang Li,Wenfang Yang,Min Zhang,Yue Cheng,Lingxia Zeng,Danli Liu,Hong Yan

doi:10.1038/s41598-018-32171-1

Abstract

The aim of this study was to assess the risk factors associated with the behavioral development among 24-month-old children in rural northwestern China. A total of 657 children whose mothers had participated in a double-blinded, randomized, controlled trial of antenatal micronutrient supplementation in western China were followed until 24 months of age. Their mental, psychomotor, and behavioral development were assessed by the Bayley Scales of Infant Development. Multivariate logistic regression models were used to examine the factors associated with infant behavioral development. Six behavioral factors of infants were presented: activity, social adaptability, reactivity, endurance, concentration, and motor coordination. Further analysis demonstrated that maternal malnutrition, exposure to risk factors during pregnancy, and adverse birth outcomes negatively affected the behavioral development of children at 24 months, which is a common co-occurrence with cognitive and emotional problems. These results suggest that strategies to improve infant behavioral development should consider the maternal pregnancy status.

Highlights

The WHO estimates that nearly one in five children and adolescents encounter emotional or behavioral problems at some point in their life between childhood and adolescence[1]
We focused on the modifiable risk factors associated with infant behavioral development based on maternal nutrient status, perinatal conditions, birth outcomes, and early nutritional status of the infants to provide evidence for addressing the early intervention strategies of behavioral development in children in rural areas
In this follow-up study, we assessed the behavioral development of toddlers at 24 months of age by the BSID, and mean scores increased for positive behaviors and decreased for negative behaviors

Summary

Introduction

The WHO estimates that nearly one in five children and adolescents encounter emotional or behavioral problems at some point in their life between childhood and adolescence[1]. There is growing evidence that children born with a low birth weight, preterm, or small for gestational age may be prone to behavioral problems in adolescence[9,10]. Behavioral problems may have adverse effects on social functioning and school performance, and assessment at an early age provides an opportunity to intervene and possibly prevent major problems in these areas[15]. We conducted this follow-up assessment of a population-based randomized controlled trial to analyze the features and associated factors of behavioral development among children at 24 months of age in rural northwestern China. We focused on the modifiable risk factors associated with infant behavioral development based on maternal nutrient status, perinatal conditions, birth outcomes, and early nutritional status of the infants to provide evidence for addressing the early intervention strategies of behavioral development in children in rural areas

Objectives

Methods

Results

Conclusion