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.

BMJ Public Health
|August 20, 2025
PubMed

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.
Abstract

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