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Developmental delay in moderately preterm-born children with low socioeconomic status: risks multiply
Marieke R Potijk1, Jorien M Kerstjens, Arend F Bos
1Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
The Journal of Pediatrics
|August 24, 2013
Summary
Low socioeconomic status (SES) and moderate prematurity (MP) are independent risk factors for developmental delay in preschoolers. Children with both low SES and MP face a compounded risk, requiring targeted pediatric care.
Area of Science:
- Developmental psychology
- Pediatric health
- Socioeconomic determinants of health
Background:
- Socioeconomic status (SES) and moderate prematurity (MP) are recognized risk factors for child development.
- Understanding their independent and combined effects on preschool developmental delay is crucial for early intervention.
Purpose of the Study:
- To evaluate the individual and joint impacts of low SES and moderate prematurity on developmental delay at age 4.
- To identify specific developmental domains affected by these risk factors.
Main Methods:
- A prospective cohort study of 926 moderately preterm-born (32-36 weeks gestation) and 544 term-born children.
- SES assessed via education, occupation, and income; developmental delay evaluated using the Ages and Stages Questionnaire.
- Multivariable logistic regression analyzed standardized SES and gestational age (GA) values.
Main Results:
- Overall developmental delay prevalence was higher in moderately preterm children (12.5% low SES) compared to term-born children (7.2% low SES).
- Decreasing SES showed a greater increase in developmental delay risk than decreasing GA, though not statistically significant (ORs 1.62 vs 1.34).
- Multiplicative interaction observed for communication domain, indicating combined effects of SES and GA.
Conclusions:
- Low SES and moderate prematurity independently increase the risk of preschool developmental delay.
- The combined effect of low SES and moderate prematurity presents a significant 'double jeopardy' risk.
- Pediatric care should prioritize early identification and support for moderately preterm children from low SES backgrounds.
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