Related Experiment Video
Updated: Dec 2, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Prediction of Cognitive Ability With Social Determinants in Children of Low Birth Weight
Lisa M Blair1, Jodi L Ford, P Cristian Gugiu
1Lisa M. Blair, PhD, RNC-NIC, is Postdoctoral Scholar, Perinatal Research and Wellness Center, University of Kentucky College of Nursing, Lexington. Jodi L. Ford, PhD, RN, is Associate Professor, The Ohio State University College of Nursing, Columbus. P. Cristian Gugiu, PhD, was Assistant Professor, The Ohio State University College of Education and Human Ecology, Columbus, at the time of the study completion and is now in private practice. Rita H. Pickler, PhD, RN, FAAN, is FloAnn Sours Easton Endowed Professor of Child and Adolescent Health and Director of PhD and MS in Nursing Science Programs, The Ohio State University College of Nursing, Columbus. Cindy Munro, PhD, ANP-BC, FAAN, FAANP, FAAAS, is Dean and Professor, University of Miami School of Nursing and Health Studies, Coral Gables. Cindy M. Anderson, PhD, APRN-CNP, ANEF, FAHA, FNAP, FAAN, is Senior Associate Dean for Academic Affairs and Educational Innovation and Professor, The Ohio State University College of Nursing, Columbus.
Insights
Social determinants at birth improve prediction of cognitive deficits in low birth weight children. Incorporating these factors enhances early identification beyond traditional birth weight and gestational age criteria.
Area of Science:
- Pediatrics
- Public Health
- Developmental Psychology
Background:
- Low birth weight (LBW) persists as a significant public health issue in the US, despite advances in neonatal care.
- LBW survivors face elevated risks for long-term cognitive deficits.
- Current referral criteria based solely on birth weight and gestational age may inadequately identify children at risk for cognitive impairment.
Purpose of the Study:
- To determine if social determinants, in addition to birth weight and gestational age, can better predict cognitive outcomes in school-aged children with LBW.
- To improve early identification of LBW children at risk for cognitive deficits.
Main Methods:
- Secondary analysis of the Fragile Families and Child Wellbeing Study birth cohort.
- Development of a social determinant indicator panel including maternal, familial, and community factors.
- Assessment of cognitive measures at 9 years of age.
Main Results:
- The social determinant model significantly predicted cognitive test scores, explaining 35% of the variance.
- The traditional model using only birth weight and gestational age explained only 9% of the variance.
- Social determinants demonstrated a substantial improvement in predicting cognitive outcomes.
Conclusions:
- Social determinants measurable at birth are powerful predictors of cognitive deficits in children born with low birth weight.
- Integrating social determinants into referral criteria can enhance the identification of at-risk children.
- Improved referral criteria can lead to better cognitive outcomes and resource allocation.
Background:
Despite strong prevention efforts and advances in neonatal care in recent decades, low birth weight remains a serious public health problem in the United States, and survivors remain at increased risk for lifelong problems including cognitive deficits. Current regional and local strategies for referral often rely on variable thresholds for birth weight and gestational age that may be poor analogues to cognitive risk. Improving early referral criteria offers many benefits, including improved cognitive outcomes for children and improved cost-effectiveness and resource utilization in resource-limited communities.
Objectives:
We hypothesized that social determinants measurable at birth or at birth hospital discharge, when combined with birth weight and gestational age, would offer an improvement over birth weight and gestational age alone in predicting cognitive test scores in school-aged children with low birth weight.
Methods:
We conducted a secondary analysis using a birth cohort of children from the Fragile Families and Child Wellbeing Study. We created a panel of maternal, familial, and community-level social determinant indicators from the data and examined associations with cognitive measures assessed at age of 9 years.
Results:
The final social determinant model was statistically significant and explained 35% of the total variance in composite test scores. The "standard care" model (birth weight and gestational age) only explained 9% of the variance.
Discussion:
Assessment of social determinants may offer improvement over traditional referral criteria to identify children most at risk of cognitive deficits after low birth weight.
More Related Videos
11:14A Novel Experimental and Analytical Approach to the Multimodal Neural Decoding of Intent During Social Interaction in Freely-behaving Human Infants
Published on: October 4, 2015
08:20A Within-subjects Experimental Protocol to Assess the Effects of Social Input on Infant EEG
Published on: May 3, 2017
Related Concept Videos
01:30Biological Influences on Intelligence
01:29Environmental Influences on Intelligence
01:30Information Processing Approach
01:30Socioemotional Development during Infancy
Primary Temperament Types
01:30Social Cognitive Perspective on Personality
01:15Causes of Social Behavior II: Cognitive Processes