Infant Cognitive Development Trajectory and Middle Childhood and Adolescent Development Outcomes: A Chinese Birth Cohort Study (P11-144-19)

Abstract

ObjectivesTo identify developmental trajectories of infant cognitive, examine its predictors, and associations with long-term outcomes at middle childhood and adolescence. MethodsThe data were obtained from a prospective birth cohort in 1388 infants born to women who participated in a randomized trial of antenatal micronutrient supplementation in China. Cognitive development was assessed six times from 3 to 30 months of age using Bayley Scales of Infant Development, and at middle childhood and adolescence using Wechsler Intelligence Scale for Children. Group-based trajectory modeling was applied to identify cognitive z-score developmental trajectories during the first two years of life. Multinomial logistic regression and generalized estimating equations models were performed to examine its predictors and associations with long-term outcomes, respectively. ResultsFour distinct cognitive developmental trajectories were identified: 1) “Subgroup 1: Start below average-then decrease” (3.2%), 2) “Subgroup 2: Start below average-then increase” (10.2%), 3) “Subgroup 3: Consistently average” (40.3%), and 4) “Subgroup 4: Consistently above average” (46.3%). Compared with Subgroup 4, per grade increase of maternal education reduced risk of being in Subgroup 1 by 73% (95% CI 0.54, 0.84); and small-for-gestational age birth and low birth weight were associated with 4.94 times (95% CI 2.16, 11.33) and 10.60 times (95% CI 3.57, 31.49) risk of being in Subgroup 1. Consuming antenatal multiple micronutrients ≥ 180 days (versus < 180 days of iron and/or folic acid) had an 84% (95% CI -.07, 0.98) reduced risk of being in Subgroup 1 and a 63% (95% CI 0.10, 0.84) reduced risk of being in Subgroup 2. Statistical differences in trajectories early in childhood persisted through middle childhood and early adolescence. ConclusionsOur findings highlight the importance of promoting interventions as early as possible. Integration of nutritional and educational interventions to address multiple health and development domains is necessary to reduce the risk of suboptimal developmental outcomes across the life course. Funding SourcesThe study was supported by the National Natural Science Foundation of China and China Scholarship Council.