Interpregnancy intervals and child development at age 5: a population data linkage study

Interpregnancy intervals and behavioural outcomes in children: A population-based longitudinal study

BACKGROUND

While the physical health consequence of short interpregnancy intervals (IPIs) is well documented, its mental health impact is not well explored. This study aimed to examine the associations between IPIs and behavioural outcomes in children born following the interval at four developmental time points between ages 7 and 16.

METHODS

Our study sample comprised participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort, an ongoing population-based longitudinal birth cohort in Bristol, Avon, United Kingdom. Behavioural problems, including total behavioural difficulties, hyperactivity, emotional symptoms, conduct problems, peer-problems, and problems of pro-social behaviour, were assessed using the Strengths and Difficulties Questionnaire (SDQ). Over 2300 mothers and their singleton children were included in this study. Generalized Estimating Equations (GEE) were used to estimate odds ratios for the associations.

RESULTS

Children born to mothers with short IPI (<6 months) were 1.54 (95%CI: 1.12-2.11), 1.42 (95% CI: 1.12-1.81) and 1.37 (95%CI: 1.04-1.79) times more likely to have total behavioural difficulties, conduct problems and hyperactivity/inattention problems across the child's age, respectively, compared with children of mothers with IPIs of 18-23 months. We found no evidence of associations between short IPI (<6 months) and emotional symptoms, peer-relationship problems and pro-social behaviour problems.

CONCLUSION

Short IPI (<6 months) was associated with externalising (conduct and hyperactivity/inattention) but not internalising (emotional and peer-relationship problems) problems. Further studies are needed to confirm this association and elucidate the underlying mechanisms.

Perinatal and early life risk factors of adverse early childhood developmental outcomes: Protocol for systematic review using socioecological model

BACKGROUND

Adverse early childhood developmental outcomes impact later schooling and adulthood life courses. However, there needs to be more comprehensive evidence on the effect of various perinatal and early life risk exposures. Hence, we aimed to systematically identify the various perinatal and early childhood risk factors using a socioecological model to inform appropriate prevention strategies.

METHOD

The systematic review will adhere to the 2020 PRISMA guidelines. The protocol was registered in PROSPERO with a registration number of CRD42023447352. We will systematically search for articles on adverse early childhood developmental outcomes, which include physical, cognitive, language and communication and social-emotional development from main databases, such as EMBASE, Medline, Global Health, PsycINFO, CINAHL and Web of Science Core Collection, dating from 2000. We will use Population, Exposure, Comparator, Outcome and Study Design (PECOS) criteria to select eligible studies for our review: 1) Population includes children in early childhood age (i.e., up to eight years) undergoing developmental assessments. 2) Exposure: various perinatal and early life risk factors. 3) Comparators: Children with no or low levels of exposure to the risk factors. 4) Outcome: adverse early childhood developmental outcome. 5) Study design: all observational studies that report the prevalence or incidence of adverse early childhood developmental outcomes and associated risk factors published since 2000. There will be no restriction based on country of origin or geographical location except language (only published in English). Textual and narrative synthesis using the socioecological model will be used to synthesise the data.

Short birth interval prevalence, determinants and effects on maternal and child health outcomes in Asia-Pacific region: a systematic review and meta-analysis protocol

BACKGROUND

Short birth interval (SBI) has been linked to an increased risk of adverse maternal, perinatal, infant and child health outcomes. However, the prevalence and maternal and child health impacts of SBI in the Asia-Pacific region have not been well understood. This study aims to identify and summarise the existing evidence on SBI including its definition, measurement prevalence, determinants and association with adverse maternal and child health outcomes in the Asia-Pacific region.

METHODS

Five databases (MEDLINE, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Maternity and Infant Care, and Web of Science (WoS)) will be systematically searched from September 2000 up to May 2023. Data will be extracted, charted, synthesised and summarised based on the outcomes measured, and where appropriate, meta-analysis will be performed. The risk of bias will be assessed using Joanna Briggs Institute quality appraisal. Grading of Recommendation Assessment, Development and Evaluation framework will be used to evaluate the quality of cumulative evidence from the included studies.

ETHICS AND DISSEMINATION

This review does not require ethics approval. Findings will be disseminated through peer-reviewed publications, policy briefs and conference presentations.

PROSPERO REGISTRATION NUMBER

A protocol will be registered on PROSPERO for each separate outcome before performing the review.Cite Now.

The effects of birth spacing on early childhood development in high-income nations: A systematic review

Objective

This study aimed to systematically review the literature on the associations between birth spacing and developmental outcomes in early childhood (3-10 years of age). Studies examining the associations between interpregnancy intervals and child development outcomes during and beyond the perinatal period have not been systematically reviewed.

Methods

We searched Ovid/MEDLINE, Global Health, PsycINFO, EMBASE, CINAHL Plus, Educational Source, Research Starters, ERIC, Scopus, PubMed, Social Science Research Network database, and ProQuest's Social Sciences Databases for relevant articles published between 1 January 1989 and 25 June 2021. Studies published in English, conducted in populations residing in high-income countries with any measure of birth spacing, and child development outcomes among children aged <10 years were included. Two authors independently assessed the eligibility of studies and extracted data on the study design, setting and population, birth spacing, outcomes, and results.

Results

The search yielded 1,556 records, of which seven studies met the inclusion criteria. Five of these seven studies used birth intervals as the exposure measure. Definitions of exposure differed between the studies. Three studies reported an association between short birth spacing and poorer child development outcomes, and two studies reported an association between long birth spacing and poorer child development outcomes.

Conclusion

Currently, limited evidence suggests that the adverse effects of sub-optimal birth spacing are observable beyond infancy.

Gestational age and child development at school entry

Studies have reported a dose-dependent relationship between gestational age and poorer school readiness. The study objective was to quantify the risk of developmental vulnerability for children at school entry, associated with gestational age at birth and to understand the impact of sociodemographic and other modifiable risk factors on these relationships. Linkage of population-level birth registration, hospital, and perinatal datasets to the Australian Early Development Census (AEDC), enabled follow-up of a cohort of 64,810 singleton children, from birth to school entry in either 2009, 2012, or 2015. The study outcome was teacher-reported child development on the AEDC with developmental vulnerability defined as domain scores < 10th percentile of the 2009 AEDC cohort. We used modified Poisson Regression to estimate relative risks (RR) and risk differences (RD) of developmental vulnerability between; (i) preterm birth and term-born children, and (ii) across gestational age categories. Compared to term-born children, adjustment for sociodemographic characteristics attenuated RR for all preterm birth categories. Further adjustment for modifiable risk factors such as preschool attendance and reading status at home had some additional impact across all gestational age groups, except for children born extremely preterm. The RR and RD for developmental vulnerability followed a reverse J-shaped relationship with gestational age. The RR of being classified as developmentally vulnerable was highest for children born extremely preterm and lowest for children born late-term. Adjustment for sociodemographic characteristics attenuated RR and RD for all gestational age categories, except for early-term born children. Children born prior to full-term are at a greater risk for developmental vulnerabilities at school entry. Elevated developmental vulnerability was largely explained by sociodemographic disadvantage. Elevated vulnerability in children born post-term is not explained by sociodemographic disadvantage to the same extent as in children born prior to full-term.