Maternal mental health predicts risk of developmental problems at 3 years of age: follow up of a community based trial
1 Department of Paediatrics, University of Calgary, Calgary, Alberta, T2T 5C7, Canada
2 Department of Community Health Sciences, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
3 Decision Support Research Team, Calgary Health Region, Calgary, Alberta, T2T 5C7, Canada
4 Faculty of Nursing, University of Calgary, Calgary, Alberta, T2N 1N4, Canada
5 Child and Youth Studies, Mount Royal College, Calgary, Alberta, T3E 6K6, Canada
BMC Pregnancy and Childbirth 2008, 8:16 doi:10.1186/1471-2393-8-16Published: 6 May 2008
Undetected and untreated developmental problems can have a significant economic and social impact on society. Intervention to ameliorate potential developmental problems requires early identification of children at risk of future learning and behaviour difficulties. The objective of this study was to estimate the prevalence of risk for developmental problems among preschool children born to medically low risk women and identify factors that influence outcomes.
Mothers who had participated in a prenatal trial were followed up three years post partum to answer a telephone questionnaire. Questions were related to child health and development, child care, medical care, mother's lifestyle, well-being, and parenting style. The main outcome measure was risk for developmental problems using the Parents' Evaluation of Developmental Status (PEDS).
Of 791 children, 11% were screened by the PEDS to be at high risk for developmental problems at age three. Of these, 43% had previously been referred for assessment. Children most likely to have been referred were those born preterm. Risk factors for delay included: male gender, history of ear infections, a low income environment, and a mother with poor emotional health and a history of abuse. A child with these risk factors was predicted to have a 53% chance of screening at high risk for developmental problems. This predicted probability was reduced to 19% if the child had a mother with good emotional health and no history of abuse.
Over 10% of children were identified as high risk for developmental problems by the screening, and more than half of those had not received a specialist referral. Risk factors for problems included prenatal and perinatal maternal and child factors. Assessment of maternal health and effective screening of child development may increase detection of children at high risk who would benefit from early intervention.
Current Controlled Trials ISRCTN64070727