Impact of Hospitalizations due to Chronic Health Conditions on Early Child Development

Joanna E Fardell; Nan Hu; Claire E Wakefield; Glenn Marshall; Jane Bell; Raghu Lingam; Natasha Nassar

doi:10.1093/jpepsy/jsad025

Impact of Hospitalizations due to Chronic Health Conditions on Early Child Development

J Pediatr Psychol. 2023 Oct 20;48(10):799-811. doi: 10.1093/jpepsy/jsad025.

Authors

Joanna E Fardell^{1

2}, Nan Hu³, Claire E Wakefield^{1

2}, Glenn Marshall², Jane Bell⁴, Raghu Lingam³, Natasha Nassar⁴

Affiliations

¹ Behavioural Sciences Unit, School of Women's and Children's Health, UNSW Sydney, Australia.
² Kids Cancer Centre, Sydney Children's Hospital, Australia.
³ Population Child Health Research Group, School of Women's and Children's Health, University of New South Wales, Australia.
⁴ Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, University of Sydney, Australia.

PMID: 37105227
DOI: 10.1093/jpepsy/jsad025

Abstract

Objective: To assess the impact of hospitalization for chronic health conditions on early child development and wellbeing at school start.

Methods: We conducted a longitudinal cohort study of children starting school using population-based record linkage of routinely collected admitted hospital data and standardized assessment of early childhood development (Australian Early Developmental Census: AEDC). Developmental vulnerability (DV) was defined as children scoring <10th centile in any one of five developmental domains. Children scoring <10th centile on two or more domains were considered developmentally high-risk (DHR). Children hospitalized with chronic health conditions were compared to children without hospitalizations prior to school start.

Results: Among 152,851 children with an AEDC record, 22,271 (14·6%) were hospitalized with a chronic condition. Children hospitalized with chronic health conditions were more likely to be DHR (adjusted odds ratio 1.25, 95% CI: 1.18-1.31) compared to children without hospitalizations. Children hospitalized more frequently (>7 times) or with longer duration (>2 weeks) had a 40% increased risk of being DHR (1.40, 95% CI: 1.05-1.88 and 1.40, 95% CI: 1.13-1.74, respectively). Children hospitalized with mental health/behavioral/developmental conditions had the highest risk of DHR (2.23, 95% CI: 1.72-2.90). Developmental vulnerability was increased for physical health (1.37, 95% CI: 1.30-1.45), language (1.28, 95% CI: 1.19-1.38), social competence (1.22, 95% CI: 1.16-1.29), communication (1.17, 95% CI: 1.10-1.23), and emotional maturity (1.16, 95% CI: 1.09-1.23).

Conclusions: Frequent and longer duration hospitalizations for chronic health conditions can impact early childhood development. Research and interventions are required to support future development and well-being of children with chronic health conditions who are hospitalized.

Keywords: chronic illness; infancy and early childhood; preschool children; public health.

Grants and funding

Maridulu Budyari Gumal