title: Prenatal and neonatal risk factors associated with children's developmental status at ages 4-7: lessons from the Jiangsu China birth defects prevention cohort.
abstract: BACKGROUND
  There is limited information involving population data about the role of maternal health, fetal growth and neonatal health on children's developmental status at ages 4-7 years. Our aim was to determine the contribution of maternal, fetal and neonatal health to developmental status at ages 4-7 years.
  
  
  METHODS
  In this 7-year follow-up prospective cohort study, a sample of 26,803 mothers participated in the beginning. Among their children, 19,187 voluntarily completed the development screening test or the social life ability survey, which were designed for two different age groups (<6 or ≥ 6 years old, respectively). Logistic regression analysis was used to link the data with the prenatal outcome card and interview questionnaire applied to pregnant women in previous study, to the analysis of various related factors such as demographic, socio-economic, disease and menstrual history, marriage and pregnancy care.
  
  
  RESULTS
  Univariate and multivariate logistic regression analysis were used separately in two age groups [4-6 (n = 8439) and 6-7 (n = 10,748) years old] to analyse relative factors. Maternal age of 25-30 years, maternal education of high school and greater, family income and not drinking during pregnancy were associated with higher scores in development.
  
  
  CONCLUSIONS
  Both preconception and pregnancy health education and health care are the important maternal factors closely associated with children's cognitive and social competence. Public health policies for preconception care and public welfare for high-quality childcare are essential for improving children's life.
authors.affiliation: Genitalia Hygiene Research Center, Jiangsu Institute of Planned Parenthood Research, Nanjing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Child Health Care Department, Children's Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: X-N
authors.initials: XN
authors.lastname: Li
authors.affiliation: Genitalia Hygiene Research Center, Jiangsu Institute of Planned Parenthood Research, Nanjing, China.
authors.forename: X-R
authors.initials: XR
authors.lastname: Sun
authors.affiliation: Genitalia Hygiene Research Center, Jiangsu Institute of Planned Parenthood Research, Nanjing, China.
authors.forename: Q-L
authors.initials: QL
authors.lastname: Liu
authors.affiliation: Genitalia Hygiene Research Center, Jiangsu Institute of Planned Parenthood Research, Nanjing, China.
authors.forename: S-W
authors.initials: SW
authors.lastname: Zha
authors.affiliation: Child Health Care Department, Children's Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Y-H
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Child Health Care Department, Children's Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: C-T
authors.initials: CT
authors.lastname: Mao
authors.affiliation: Genitalia Hygiene Research Center, Jiangsu Institute of Planned Parenthood Research, Nanjing, China.
authors.forename: X-Y
authors.initials: XY
authors.lastname: Xu
mesh_terms: D000328:Adult; D002657:Child Development; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000523:psychology; D011050:Policy Making; D011159:Population Surveillance; D016742:Preconception Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011634:Public Health; D018570:Risk Assessment; D012307:Risk Factors
keywords: 7 years follow-up; cognitive and social competence; logistic regression analysis; population-based; preschool child