title: Socioeconomic disadvantage and neural development from infancy through early childhood.
abstract: BACKGROUND
  Early social experiences are believed to shape neurodevelopment, with potentially lifelong consequences. Yet minimal evidence exists regarding the role of the social environment on children's neural functioning, a core domain of neurodevelopment.
  
  
  METHODS
  We analysed data from 36 443 participants in the United States Collaborative Perinatal Project, a socioeconomically diverse pregnancy cohort conducted between 1959 and 1974. Study outcomes included: physician (neurologist or paediatrician)-rated neurological abnormality neonatally and thereafter at 4 months and 1 and 7 years; indicators of neurological hard signs and soft signs; and indicators of autonomic nervous system function.
  
  
  RESULTS
  Children born to socioeconomically disadvantaged parents were more likely to exhibit neurological abnormalities at 4 months [odds ratio (OR) = 1.20; 95% confidence interval (CI) = 1.06, 1.37], 1 year (OR = 1.35; CI = 1.17, 1.56), and 7 years (OR = 1.67; CI = 1.48, 1.89), and more likely to exhibit neurological hard signs (OR = 1.39; CI = 1.10, 1.76), soft signs (OR = 1.26; CI = 1.09, 1.45) and autonomic nervous system dysfunctions at 7 years. Pregnancy and delivery complications, themselves associated with socioeconomic disadvantage, did not account for the higher risks of neurological abnormalities among disadvantaged children.
  
  
  CONCLUSIONS
  Parental socioeconomic disadvantage was, independently from pregnancy and delivery complications, associated with abnormal child neural development during the first 7 years of life. These findings reinforce the importance of the early environment for neurodevelopment generally, and expand knowledge regarding the domains of neurodevelopment affected by environmental conditions. Further work is needed to determine the mechanisms linking socioeconomic disadvantage with children's neural functioning, the timing of such mechanisms and their potential reversibility.
authors.affiliation: Department of General Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan Department of Public Health, School of Medicine, National Yang Ming University, Taipei, Taiwan.
authors.forename: Galen
authors.initials: G
authors.lastname: Chin-Lun Hung
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Hahn
authors.affiliation: Section of Child & Adolescent Psychiatry, Lahey Hospital & Medical Center, Burlington, MA, USA Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Bibi
authors.initials: B
authors.lastname: Alamiri
authors.affiliation: Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Buka
authors.affiliation: Departments of Psychiatry and Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Goldstein
authors.affiliation: Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Nan
authors.initials: N
authors.lastname: Laird
authors.affiliation: Department of Pediatrics, Harvard Medical School/Boston Children's Hospital, Boston, MA, USA.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Nelson
authors.affiliation: Psychiatric and Neurodevelopmental Genetics Unit Department of Psychiatry Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Smoller
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA Department of Psychiatry Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA stephen.gilman@nih.gov.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Gilman
mesh_terms: D001342:Autonomic Nervous System Diseases / Q000453:epidemiology* / Q000503:physiopathology; D001720:Birth Injuries / Q000453:epidemiology; D002648:Child; D002657:Child Development; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009043:Motor Activity / Q000502:physiology; D009129:Muscle Tonus / Q000502:physiology; D009422:Nervous System Diseases / Q000453:epidemiology* / Q000503:physiopathology; D009460:Neurologic Examination; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology; D012307:Risk Factors; D012923:Social Class; D014481:United States / Q000453:epidemiology; D014666:Vasomotor System / Q000503:physiopathology
keywords: Neural development; neurological abnormality; socioeconomic status; soft signs