Abstract
Objective
To determine the effect of exposure to multiple social risks on cognitive delay at
9 months of age; and whether obstetric factors mediate the relationship between cumulative
social risk and cognitive delay.
Methods
Data were from 8950 mother–child dyads participating in the first wave of the Early
Childhood Longitudinal Study, Birth Cohort. Cognitive delay was defined as falling
in the lowest 10% of mental scale scores from the Bayley Short Form–Research Edition.
Five social risk factors were combined and categorized into a social risk index. Staged
multivariable logistic regressions were used to investigate whether obstetric factors
mediated the impact of social risk on the odds of cognitive delay.
Results
Infants with cognitive delay were more likely to live with social risks than infants
without cognitive delay. The percentage of infants with cognitive delay increased
with the number of social risks. In adjusted analyses, exposure to multiple social
risk factors was associated with higher odds of cognitive delay at 9 months of age
(adjusted odds ratio 2.11; 95% confidence interval 1.18–3.78 for 4 or more risks vs
no risks). Accounting for birth weight attenuated this relationship (P < .001).
Conclusions
This population-based study investigated the independent and cumulative effects of
social risk factors on cognitive delay in infancy. Findings revealed a significant
cumulative relationship between exposure to social risk and cognitive delay, which
was partly mediated by birth weight. Programs that address the social context of US
infants are needed to improve their developmental trajectories.
Keywords
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Article Info
Publication History
Accepted:
March 30,
2014
Received:
December 31,
2013
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
