title: Perinatal and socioeconomic risk factors for variable and persistent cognitive delay at 24 and 48 months of age in a national sample.
abstract: The objective of this paper is to examine patterns of cognitive delay at 24 and 48 months and quantify the effects of perinatal and sociodemographic risk factors on persistent and variable cognitive delay. Using data from 7,200 children in the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B), multiple logistic regression models identified significant predictors of low cognitive functioning at 24 and 48 months. Additional multiple logistic models predicting cognitive delay at 48 months were estimated separately for children with and without delay at 24 months. Of the nearly 1,000 children delayed at 24 months, 24.2% remained delayed by 48 months; 7.9% of the children not delayed at 24 months exhibited delay at 48 months. Low and very low birthweight increased cognitive delay risk at 24, but not 48 months. Low maternal education had a strongly increasing effect (OR = 2.3 at 24 months, OR = 13.7 at 48 months), as did low family income (OR = 1.4 at 24 months, OR = 7.0 at 48 months). Among children delayed at 24 months, low maternal education predicted delay even more strongly at 48 months (OR = 30.5). Low cognitive functioning is highly dynamic from 24 to 48 months. Although gestational factors including low birthweight increase children's risk of cognitive delay at 24 months, low maternal education and family income are more prevalent in the pediatric population and are much stronger predictors of both persistent and emerging delay between ages 24 and 48 months.
authors: Department of Health Policy and Administration, Pennsylvania State University, 504S Ford Building, University Park, PA, 16802, USA. mmh18@psu.edu
authors: Marianne M
authors: MM
authors: Hillemeier
authors: Paul L
authors: PL
authors: Morgan
authors: George
authors: G
authors: Farkas
authors: Steven A
authors: SA
authors: Maczuga
mesh_terms: D002657:Child Development; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009460:Neurologic Examination; D018743:Perinatal Care; D011247:Pregnancy; D011248:Pregnancy Complications; D012307:Risk Factors; D012923:Social Class; D014481:United States