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BACKGROUND: Preterm children are at increased risk of cognitive and language delay compared with term-born children. While many perinatal factors associated with prematurity are well established, there is limited research concerning the influence of the socio-familial environment on the development of preterm children. This study aims to assess the relative impact of perinatal and socio-familial risk factors on cognitive and language development at 2 years corrected age (CA). METHOD: This retrospective cross-sectional study included preterm infants with a gestational age <32 weeks and/or a birth weight <1500 g, who underwent neurodevelopmental assessment at 2 years CA. Cognitive and language scores were assessed using the Bayley Scales of Infant-Toddler Development, third edition. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated using a multivariable model to examine the relationship between developmental delays and perinatal and socio-familial factors. RESULT: The prevalence of language delay was negatively associated with daycare attendance (aOR: 0.25, 95% CI: 0.07-0.85, p < 0.05) and high maternal educational levels (aOR: 0.24, 95% CI: 0.05-0.93, p < 0.05) and positively associated with bilingual environments (aOR: 5.62, 95% CI: 1.46-24.3, p < 0.05). Perinatal and postnatal risk factors did not show a significant impact on cognitive or language development. CONCLUSION: The development of language appears to be more influenced by the socio-familial environment than by early perinatal and postnatal factors associated with prematurity. These findings highlight the importance of considering socio-familial factors in the early identification and intervention of language delay among preterm children.
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Lactente Extremamente Prematuro , Transtornos do Desenvolvimento da Linguagem , Lactente , Gravidez , Feminino , Criança , Recém-Nascido , Humanos , Lactente Extremamente Prematuro/psicologia , Deficiências do Desenvolvimento/epidemiologia , Estudos Retrospectivos , Estudos Transversais , Desenvolvimento da Linguagem , Desenvolvimento Infantil , Idade Gestacional , Transtornos do Desenvolvimento da Linguagem/etiologia , Transtornos do Desenvolvimento da Linguagem/complicações , Cognição , Recém-Nascido de muito Baixo PesoRESUMO
BACKGROUND: Fetal growth restriction (FGR) may be related to ethnicity. Additionally, ethnic groups experience adverse socioeconomic circumstances that increase FGR risk. However, the dearth of evidence of the interaction between socioeconomic factors and FGR highlights the need for additional research. OBJECTIVE: To analyze the association between socioeconomic factors and FGR in Maya and non-Maya populations in Yucatan, Mexico. METHODS: A total of 21,320 singleton births in 2017 in Yucatan were analyzed. The student's t-test and the chi-square test were used to compare the means and proportions of maternal and perinatal variables between the FGR group and the birthweight appropriate for gestational age (AGA) group. Path analysis was performed to identify the direct and indirect effects of socioeconomic factors on FGR and mediators between predictors and FGR. RESULTS: The prevalence of FGR at birth was 9.06%; this rate was higher in the Maya population (12.4, 95% CI 11.3-13.5), without differences between socioeconomic levels. Path analysis revealed sociostructural variables (ethnicity and poverty) are reliable predictors of FGR at birth mediated by maternal education (ß = -.152, p < .001) and teenage pregnancy (ß = .065, p = .037). The proposal path model had a good fit index CFI = .968, TLI = .920, RMSEA = .046. CONCLUSION: The prevalence of FGR was higher among Maya women than non-Maya women The socioeconomic conditions associated with FGR at birth were ethnicity, poverty, maternal education, and teenage pregnancy. Maternal education and teenage pregnancy act as mediators between sociostructural variables and FGR at birth.
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Retardo do Crescimento Fetal , Fatores Sociodemográficos , Gravidez , Recém-Nascido , Adolescente , Feminino , Humanos , México/epidemiologia , Retardo do Crescimento Fetal/epidemiologia , Peso ao Nascer , Idade GestacionalRESUMO
Evidence has identified unhealthy lifestyle behaviors as the main contributors to obesity in children, so it is essential to identify factors that could influence children's lifestyles. The objective of the present study was to analyze the association of baseline maternal educational level with child's physical activity, screen time, and dietary habits at follow-up. This community-based cohort study was carried out between 2012 and 2014 and included 1405 children aged 8 to 10 years old. Maternal educational level was used as an indicator of child's socioeconomic status. Physical activity, screen time, and dietary habits were assessed by validated questionnaires. The odds of having commercially baked goods for breakfast [OR 1.47 (95% CI 1.03 to 2.10)], going more than once a week to a fast-food restaurant [OR 1.64 (95% CI 1.20 to 2.26)], and taking sweets and candys several times a day [OR 3.23 (95% CI 2.14 to 4.87) were significantly higher among children whose mothers had a lower educational level compared to their peers whose mothers had a higher level. These associations held for taking sweets and candy several times a day after additional adjustment for the corresponding dietary behavior at baseline. Maternal educational level was inversely associated (p < 0.001) with child's screen time at follow up and being in the lowest maternal educational category was associated with an increased odds of surpassing the maximum recommended time of screen time of 120 min per day (OR (95% CI) 1.43 (1.07 to 1.90), p = 0.016). Maternal education is a predictor for unhealthy dietary habits and high screen time in children.
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Fenômenos Fisiológicos da Nutrição Infantil , Escolaridade , Exercício Físico/estatística & dados numéricos , Comportamento Alimentar , Relações Mãe-Filho , Tempo de Tela , Adulto , Criança , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Classe Social , Inquéritos e QuestionáriosRESUMO
Resumen La teoría de la mente (ToM) es la capacidad de reconocer los propios estados mentales y predecir los de otros, habilidad fundamental en el desarrollo socioemocional/cognitivo en preescolares. El presente estudio buscó describir la ToM de niños chilenos de 3 y 4 años, analizar las diferencias en su desarrollo según la edad y el rol mediador del lenguaje mentalizante (LM) materno, considerando el sexo de los niños, los modelos operantes internos (MOI) y el nivel educacional materno. La muestra fueron 110 niños con sus madres. Se aplicó un cuestionario sociodemográfico, pruebas para evaluar la ToM, el LM y los MOI de las madres. Un 50.9% de los niños se ubicó en el quintil 1 de la ToM y ninguno logró llegar al quinto. Las habilidades de la ToM con un mayor nivel de logro diferenciaron entre pretender y realidad (60.0%) y la de diferenciar la perspectiva visual propia y de otro (50.9%). Un 59.1 % de los niños no logró inferir deseos a través de la mirada, un 83.6% no logró la habilidad de acceso al conocimiento, y un 100% no logró la falsa creencia. Los resultados muestran diferencias significativas entre niños de distintos rangos etarios en el desarrollo de la ToM, sugiriendo una creciente dificultad de adquisición de sus habilidades. Además, un mayor LM de las madres se relacionó con mayor desarrollo de la ToM en los niños, con un rol mediador en la influencia de los MOI y nivel educacional materno sobre la ToM.
Abstract The theory of mind (ToM) is the ability to recognize one's own mental states and infer them in others, fundamental in socio-emotional/cognitive development in preschoolers. This study sought to describe the ToM of 3- and 4-year-old Chilean children, to analyze the differences in their development according to age, and the mediating role of maternal mentalizing language (ML) considering the sex of the children, the internal working models (IWM) and maternal educational level. The sample considered 110 children with their mothers. A sociodemographic questionnaire, tests to evaluate the ToM, the ML and the IWM of the mothers were applied. 50.9% of the children were in quintile 1 of the ToM and none managed to reach the fifth. The ToM skills with a higher level of achievement were differentiating between pretending and reality (60.0%) and differentiating one's own visual perspective and another's (50.9%). 59.1 % of the children did not manage to infer wishes through the gaze, 83.6% did not achieve the ability to access knowledge, and 100% did not achieve the false belief. The results show significant differences between children of different age ranges in the development of ToM, suggesting a growing difficulty in acquiring their skills. In addition, a higher ML in mothers was related to a greater development of ToM in children, with a mediating role in the influence of IWM and maternal educational level on ToM.
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BACKGROUND: In adults, low level of education was shown to be associated with higher blood pressure levels and alterations in cardiac structures and function. It is currently unknown whether socioeconomic inequalities in arterial and cardiac alterations originate in childhood. Therefore, we investigated the association of maternal education with blood pressure levels, arterial stiffness, and cardiac structures and function at the age of 6 years and potential underlying factors. METHODS: The study included 5,843 children participating in a prospective cohort study in the Netherlands. Maternal education was assessed at enrollment. Blood pressure, carotid-femoral pulse wave velocity, left atrial diameter, aortic root diameter, left ventricular mass, and fractional shortening were measured at the age of 6 years. RESULTS: Children with low educated (category 1) mothers had higher systolic (2.80mm Hg; 95% confidence interval (CI) = 1.62-2.94) and diastolic (1.80mm Hg; 95% CI = 1.25-2.35) blood pressure levels compared with children with high educated (category 4) mothers. The main explanatory factors were the child's body mass index (BMI), maternal BMI, and physical activity. Maternal education was negatively associated with fractional shortening (P trend = 0.008), to which blood pressure and child's BMI contributed the most. No socioeconomic gradient was observed in other arterial and cardiac measurements. CONCLUSIONS: Socioeconomic inequalities in blood pressure are already present in childhood. Higher fractional shortening among children from low socioeconomic families might be a first cardiac adaptation to higher blood pressure and higher BMI. Interventions should be aimed at lowering child BMI and increasing physical activity among children from low socioeconomic families.
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Pressão Sanguínea , Doenças Cardiovasculares/etiologia , Mães , Rigidez Vascular , Função Ventricular Esquerda , Adulto , Fatores Etários , Índice de Massa Corporal , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Criança , Escolaridade , Feminino , Humanos , Masculino , Atividade Motora , Contração Miocárdica , Países Baixos , Estudos Prospectivos , Fatores de RiscoRESUMO
OBJECTIVE: To examine the association between socioeconomic position (SEP) and umbilical and uterine placental resistance indices in the second and third trimester, and to what extent this could be explained by lifestyle-related behaviors. DESIGN: Prospective cohort study. SETTING: Rotterdam, the Netherlands. PATIENT(S): 7,033 pregnant women of mean age (± standard deviation) 29.9 (±5.2) years. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Uterine artery resistance index (UARI) and umbilical artery pulsatility index (UAPI) in second and third trimester measured with Doppler ultrasound. RESULT(S): Third-trimester UARI and both second- and third-trimester UAPI were statistically significantly higher for women with lower educational levels as compared with those with higher educational levels. Educational level was strongly associated with the risk of continuously high levels of UARI and UAPI from second to third trimester of pregnancy. Notching was not associated with SEP. Smoking was a significant contributor to the association of SEP and increased placental resistance indices; body mass index, folic acid supplementation use, and alcohol use were not. CONCLUSION(S): Women from low socioeconomic subgroups have higher placental resistance indices, which may cause a higher prevalence of pregnancy complications. This was mainly explained by maternal smoking during pregnancy.
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Placenta/irrigação sanguínea , Placenta/patologia , Vigilância da População , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/economia , Resistência Vascular/fisiologia , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Vigilância da População/métodos , Gravidez , Complicações na Gravidez/epidemiologia , Estudos Prospectivos , Fatores Socioeconômicos , Adulto JovemRESUMO
Resumen En la provincia de San Luis (Argentina), se desarrollaron dos estudios con el propósito de conocer la incidencia de factores socioambientales en el desarrollo cognitivo de los niños. En la primera investigación se trabajó con una muestra de niños de alto riesgo entre 6 y 12 meses y, en la segunda, con una muestra de niños sanos de 6 a 9 años. Las evaluaciones cognitivas se llevaron a cabo mediante la aplicación de la Escala Argentina de Inteligencia Sensorio Motriz (EAIS) en la primera investigación y la versión argentina de la Escala de Inteligencia de Wechsler (WISC-IV) en la segunda. Los resultados reflejan que la variable ambiental nivel educativo materno incide en el rendimiento cognitivo alcanzado por los niños de 6 a 9 años, porque a medida en que aumenta la escolaridad materna mejoran los percentiles obtenidos por sus hijos. Sin embargo, no ocurre lo mismo en los bebés evaluados entre los 6 y los 12 meses de vida. Como conclusión, se remarca la importancia de los primeros años de vida en el crecimiento, la maduración y el desarrollo posterior del niño, así como el impacto que el medio familiar, cultural y social puede tener sobre los mismos. Además, se entiende al desarrollo cognitivo como un proceso multideterminado por aspectos subjetivos, ambientales, históricos-sociales y genéticos, entre otros.
Abstract Preliminary results are presented from two studies carried out in the province of San Luis, Argentina in which cognitive development in children was evaluated. A sample of high-risk children between 6 and 12 months of age was used in the first study, and in the second a sample of healthy children aged 6-9 years was used. Cognitive assessments were carried out by applying the Argentine Sensory-Motor Intelligence Scale (EAIS) in the first study and the Argentine version of the Wechsler Intelligence Scale (WISC-IV) in the second study. The aim of this work is to discern what factors can affect cognitive development in children. The results reflect that the environmental variable, maternal educational level, affects the cognitive performance achieved by children from 6 to 9 years of age, since as maternal schooling increases the percentiles obtained by their children also rise. However, this was not the case in those infants evaluated between 6 and 12 months of age. We conclude about the importance of early life in growth, maturation and subsequent child development and the impact that family, cultural and social environments may have on them. Cognitive development is understood as a multi-determined process with subjective, environmental, historical and social and genetic aspects, among others.
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Humanos , Masculino , Feminino , Lactente , Criança , Desempenho Psicomotor , Cognição , Escolaridade , Argentina , Terapia SocioambientalRESUMO
A efectos de explorar la relación entre rendimiento intelectual y nivel educativo materno, en el presente estudio piloto se analizan 50 díadas madre-hijo. El rendimiento cognitivo de los menores se evaluó a través de la Escala de Inteligencia para Niños de Wechsler -cuarta edición (WISCIV) en su adaptación argentina, y los años de educación materna a partir de un cuestionario sociodemográfico. Los resultados indicaron correlaciones significativas entre las dos variables evaluadas. De este modo, se constata la relevancia de la educación materna como predictor del rendimiento en el WISC-IV. Las conclusiones ratifican la necesidad de reconocer los factores socio-ambientales que rodean al sujeto para desarrollar una interpretación más completa de la producción registrada en el test.
This research paper aims to explore the relationship between intellectual performance and maternal educational level. 50 mother-child couples were sampled. To assess the children's cognitive performance, the Wechsler (4th edition (WISC-IV) scale and a demographic questionnaire of maternal education were used. The results showed significant correlations between the two variables. Consequently, maternal education as relevant performance predictor in WISC-IV scale is confirmed. The conclusions also prove the need to recognize socio-environmental factors around this subject to develop a more comprehensive interpretation related to the test results.