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Clustering of circumstances during the first 1000 days after conception and their association with school
Malon Van den Hof1,2,3,4, Ilona Veer4, Ruben van Gaalen4,5
1Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Insights
Clustering of socioeconomic, biomedical, and adverse childhood experiences in the first 1000 days is linked to poorer school performance. Children in resource-poorest environments face developmental challenges, highlighting the need for early life support.
Area of Science:
- Developmental Pediatrics
- Public Health
- Socioeconomic Determinants of Health
Background:
- The first 1000 days of life represent a critical window for development.
- Understanding how various factors cluster during this period and impact later outcomes is crucial.
- Current knowledge on the clustering of diverse risk factors and their combined effect is limited.
Purpose of the Study:
- To investigate the clustering of socioeconomic, prenatal/perinatal biomedical, and adverse childhood experiences within the first 1000 days of life.
- To examine the association between identified clusters and school performance at age 12.
Main Methods:
- Population-based cohort study using registry data of all children born in the Netherlands in 2006.
- Latent class analysis employed to identify clusters of circumstances.
- School performance assessed by the highest secondary school level advice at age 12.
Main Results:
- Five distinct clusters were identified, ranging from 'resource-richest' to 'resource-poorest'.
- The 'resource-poorest' cluster (5% of children) exhibited a higher prevalence of adverse factors across all domains.
- Children in the 'resource-poorest' cluster showed significantly poorer school performance compared to those in the 'resource-richest' cluster (OR 0.13, 95% CI 0.11 to 0.14).
Conclusions:
- Clustering of multiple risk factors during the first 1000 days is associated with diminished school performance.
- Children in resource-limited environments during this critical period may not reach their full educational potential.
- Policies supporting resources across multiple domains early in life are vital for long-term human potential.
Background:
The first 1000 days of life are a crucial foundational period during which many different factors can impact development. It is unknown to what extent different factors cluster and how this affects later-life outcomes.
Methods:
In this population-based cohort study, we used registry data of all children born in the Netherlands in 2006. We used latent class analysis to investigate clustering of circumstances in the first 1000 days of life, including socioeconomic indicators (household income, parental education), prenatal and perinatal biomedical factors (maternal age, late-start antenatal care, preterm birth/born small for gestational age/poor start in life), and adverse childhood experiences in the first 1000 days (parental death, separation, mental health problems and detention) and associated clusters with school performance (ie, highest secondary school level advice at age 12).
Results:
In the study population of 181 575 children, we identified five clusters. We labelled cluster 1 (39%) and cluster 2 (27%) as 'resource-richest', clusters 3 (15%) and 4 (15%) as 'intermediate', and cluster 5 (5%) as 'resource-poorest', with the latter having the highest probabilities of low socioeconomic resources, adverse prenatal and perinatal biomedical factors and adverse childhood experiences in the first 1000 days. Compared with those in the resource-richest cluster (cluster 2), children in the resource-poorest cluster (cluster 5) had poorer school performance (OR 0.13, 95% CI 0.11 to 0.14), also after adjustment for parental education and household income (OR 0.20, 95% CI 0.18 to 0.24).
Conclusions:
Clustering of risk factors across different domains during the first 1000 days of life was associated with poorer school performance at age 12, suggesting that children growing up in resource-limited environments during this critical developmental window may face challenges in reaching their full developmental and educational potential. If we find similar associations with health-related outcomes, this would further underscore the importance of policies that strengthen resources across multiple domains early in life to support long-term human potential.
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