Early childhood trajectories of domain-specific developmental delay and gestational age at birth: An analysis of the All Our Families cohort

PLoS One. 2023 Dec 27;18(12):e0294522. doi: 10.1371/journal.pone.0294522. eCollection 2023.

Abstract

Objective: To describe developmental domain-specific trajectories from ages 1 through 5 years and to estimate the association of trajectory group membership with gestational age for children born between ≥34 and <41 weeks gestation.

Methods: Using data from the All Our Families cohort, trajectories of the domain-specific Ages & Stages Questionnaire scores were identified and described using group-based trajectory modeling for children born ≥34 and <41 weeks of gestation (n = 2664). The trajectory groups association with gestational age was estimated using multinomial logistic regression.

Results: Across the five domains, 4-5 trajectory groups were identified, and most children experienced changing levels of risk for delay over time. Decreasing gestational age increases the Relative risk of delays in fine motor (emerging high risk: 1.46, 95% CI: 1.19-1.80; resolving moderate risk: 1.11, 95% CI: 1.03-1.21) and gross motor (resolving high risk: 1.21, 95% CI: 1.04-1.42; and consistent high risk: 1.64, 95% CI: 1.20-2.24) and problem solving (consistent high risk: 1.58 (1.09-2.28) trajectory groups compared to the consistent low risk trajectory groups.

Conclusion: This study highlights the importance of longitudinal analysis in understanding developmental processes; most children experienced changing levels of risk of domain-specific delay over time instead of having a consistent low risk pattern. Gestational age had differential effects on the individual developmental domains after adjustment for social, demographic and health factors, indicating a potential role of these factors on trajectory group membership.

MeSH terms

  • Child
  • Child, Preschool
  • Gestational Age*
  • Humans
  • Infant
  • Infant, Newborn
  • Logistic Models
  • Risk Factors
  • Surveys and Questionnaires

Grants and funding

NS was funded throughout this work by the Alberta Children’s Hospital Research Institute Graduate Scholarship, the Alberta Graduate Excellence Scholarship, the Faculty of Graduate Studies Doctoral Scholarship, and the University of Calgary Graduate Studies Scholarship. The All Our Families cohort was funded through the Alberta Innovates Interdisciplinary Team Grant #200700595, the Alberta Children's Hospital Foundation, and the MaxBell Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.