A Study Protocol to Follow a Birth Cohort: Fars Birth Cohort

Comparing Growth and Development of Low and Normal Birth Weight Children at Age of 60 Months

Background: Low birth weight (LBW < 2500 g) is one of the most serious problems in today’s world. It is also a predictor for mortality and stunting. Objectives: This study aimed to compare the growth and development at the age of 60 months between children born with low and normal birth weight in Shiraz, Iran. Methods: This study is part of the Fars birth cohort (FBC) study with the data of children who were born in 2011. We called mothers and asked them to bring their children to the FBC clinic for further evaluation. We also determined the level of development at the age of 60 months for each child by using the Ages and Stages questionnaire (ASQ) for the children. Results: Of the children, 304 (51.4%) were girls. Most of them had normal birth weight (93.2%), had exclusive breastfeeding for five to six months (79.9%), and did not have any chronic diseases (77.8%). Growth indices at the age of 60 months were significantly higher in children with normal birth weight than in their LBW peers (P < 0.001). However, we found no significant difference in children’s development at the age of 60 months between normal and low birth weight children. Conclusions: Although growth indices of children at the age of 60 months were higher in children with normal birth weight, we found no significant difference in children’s development at the age of 60 months between normal and low birth weight children.

Socioeconomic Status and Child Developmental Delay: A Prospective Cohort Study

Background: Children with developmental delays are at higher risk of poor health, and lower educational attainment and wellbeing than the normal ones. Objectives: As previous studies had contradictory results regarding the association between socioeconomic status (SES) and child development, the current study aimed at determining this association at the age of 60 months. Methods: The current prospective cohort study was conducted in Shiraz, Iran, from summer 2011 to the end of 2016. The study was conducted on 640 mothers registered in the Fars Birth Cohort study. A checklist comprised of social and economic parts was employed. The children’s communication development was also assessed using the ages and stages questionnaire for 60-month-old children. In addition, SES was determined using 25 variables. Data analysis was performed using SPSS version 19.0 and partitioning around medoid (PAM) clustering in R 3.5.0 software; P value < 0.05 was considered as the level of significance. Results: The majority of the subjects (79.1%) were categorized as the moderate level of SES; 106 (16.56%) children had a delay in at least one developmental domain. The current study results showed that the education level of parents and the occupational status of mothers were significantly associated with delayed communication skills in children (P < 0.05). Delay in communication skills was significantly more prevalent among children whose parents had a low education level (P < 0.05). After controlling other confounders, the relative risk of delay in communication skills was 3.7 times higher among children in the moderate level of SES and almost 10 times higher among the ones in the low level of SES. Conclusions: Children brought up in families with low SES had the highest level of delay in communication skills, followed by the ones in families with moderate SES. Considering the importance of communication skills in children socialization, more attention should be paid to SES of the families with preschool kids. It seems quite reasonable if health policymakers put more emphasis on the communication skills of preschool children.

The relationship between maternal mental health and communication skills in children in Shiraz, Iran

OBJECTIVES

Child development is a significant issue in global public health, and maternal mental health (MMH) can have a remarkable effect on children’s development of communication skills. We aimed to investigate the association between MMH and communication skills in a sample of Iranian children.

METHODS

This study was conducted in Shiraz, Iran during 2016. In total, 640 mothers who lived in Shiraz and were registered in the Fars Birth Cohort (FBC) study were invited to attend the FBC clinic with their children. A trained physician evaluated MMH using the General Health Questionnaire (GHQ). Additionally, a trained nurse assessed the children’s communication development status using the Ages and Stages Questionnaire for 60-month old children.

RESULTS

The majority of the mothers were homemakers (82.8%) and had high school diplomas (38.9%). The mothers’ mean age was 33.7±4.6 years. Seventy-nine (12.3%) children had delayed communication skills, but no significant association was found between children’s communication skills and the mothers’ total GHQ score (p=0.43). In total, 493 mothers (77.0%) had abnormal somatic symptoms, 497 (77.7%) had abnormal anxiety/insomnia, 337 (52.7%) had social dysfunction, and 232 (36.3%) suffered from depression. Logistic regression indicated that after adjusting for confounders, the odds of delayed communication skills were 3-fold higher among the children of mothers with abnormal somatic symptoms than among other children (p=0.01).

CONCLUSIONS

The study results confirmed that MMH had a significant impact on children’s communication skills. Moreover, maternal abnormal somatic symptoms exerted the strongest impact on the development of communication skills in 5-yearold children.