Maternal immigrant status and signs of neurodevelopmental problems in early childhood

Abstract

Abstract Background 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 two-year-old children using standardized parent-report instruments. Methods We used data from the French representative ELFE birth cohort, initiated in 2011. The study sample included 9,900 children of non-immigrant French, 1,403 children of 2nd, and 1,171 children of 1st generation immigrant women followed-up to age two 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). Results In fully adjusted linear regression models, maternal immigrant status was positively associated with M-CHAT scores, with stronger associations in children of 1st (β-coefficient: 0.19; 95% CI 0.08-0.29) than 2nd generation immigrants (0.09; 0.01-0.17). This association was especially strong among children of 1st generation immigrant mothers native of North Africa (vs. non-immigrant French: 0.33; 0.16-0.49) or French-speaking Sub-Saharan Africa (0.26; 0.07-0.45). MB-CDI scores were lowest among children of 1st generation immigrant mothers, particularly from mostly non-francophone regions. Children of 1st generation immigrant mothers were most likely to have simultaneously low MB-CDI and high M-CHAT scores. Conclusions Our findings suggest that maternal immigrant status is associated with higher risks of early signs of neurodevelopmental difficulties, with strong variations according to maternal region of origin. Standardized screening instruments may aid the early detection and treatment of these difficulties, helping to address inequalities in neurodevelopmental health in children of immigrants. Key messages Children of immigrant mothers in a population-based sample appear to have elevated neurodevelopmental risks, as assessed by maternal report. This is in line with evidence from clinical samples. We found strong variations according to maternal region of origin, with the highest risks in children of 1st generation immigrant mothers from North Africa and French-speaking Sub-Saharan Africa.