Abstract
BackgroundPre- and postnatal factors have been found to be predictors of age at attaining milestones in infancy; however, the degree to which such factors are predictors of milestones in the subsequent years is less investigated. The aim was to conduct a systematic evaluation of a broad range of possible predictors of milestone attainment during the second and third years to identify factors that explain significant inter-individual variance.MethodsMothers of 4009 children from the Copenhagen Perinatal Cohort (1959–61) were interviewed by a physician about 20 developmental milestones at a three-year examination. Milestones were related to: Language, Walking, Eating, Dressing, Social interaction, and Toilet training. Information on possible predictors was collected during pregnancy and at a 1- and 3-year follow-up.ResultsSeveral pre- and postnatal factors were significantly associated with the timing of milestone attainment; especially parental social status, paternal age, sex, gestational age, birth weight, birth length, weight increase in the first year of life, and motor development during the first year of life. The significant predictors explained 16.2% of the variance in the Overall mean of milestones and 20.3% of the variance in milestones related to Walking. The most influential individual factor for the timing of milestone attainment was previous motor development during the first year of life. Additionally, sex was an important factor as girls were generally faster at attaining milestones. Parental social status was a consistent, but relatively week predictor.ConclusionA notable amount of variance in the timing of milestones during the first three years of life can be explained by perinatal and early postnatal factors. The study provides evidence of developmental continuity as the main predictor of milestones in the second and third years was the speed of development during the first year.
Highlights
Pre- and postnatal factors have been found to be predictors of age at attaining milestones in infancy; the degree to which such factors are predictors of milestones in the subsequent years is less investigated
None of the predictors in the domain of ‘family background’ were significantly associated with the Overall mean of milestones
We were able to explain 16.2% of the variance in the Overall mean of milestones with a model summarizing the findings in the four predictor domains ‘family background’, ‘pregnancy and delivery’, ‘postnatal factors’, and ‘postnatal growth and development’
Summary
Pre- and postnatal factors have been found to be predictors of age at attaining milestones in infancy; the degree to which such factors are predictors of milestones in the subsequent years is less investigated. Even within the normal range, early attainment of several developmental milestones has been shown to be associated with beneficial outcomes later in life. While the importance of developmental milestones is acknowledged for several outcomes, studies investigating potential predictors of the timing of these milestones are Flensborg-Madsen et al BMC Pediatrics (2019) 19:420 limited and mainly focus on language development. Early developmental factors such as gestational age [27,28,29] and low birth weight [30,31,32] have been found to be associated with later attainment of language milestones. There have been studies of developmental continuity showing that the timing of earlier motor developmental milestones may be a good predictor of the attainment of language milestones [3, 38]
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