Page 24 - Sample Moderate prematurity, socioeconomic status, and neurodevelopment in early childhood

Chapter 2
Table 3 Relative and joint effects of socioeconomic status and gestational age on developmental delay: results of three multivariate logistic regression models
ASQ Domains
Univariate
OR (95% CI)
Model 1a OR (95% CI)
Model 2b OR (95% CI)
Model 3c OR (95% CI)
Total Score
Decreasing SESd Decreasing GAe SES*GA
Fine Motor Decreasing SESd Decreasing GAe SES*GA
Gross Motor
Decreasing SESd Decreasing GAe SES*GA Communication Decreasing SESd Decreasing GAe SES*GA Problem-Solving Decreasing SESd Decreasing GAe SES*GA Personal-Social Decreasing SESd Decreasing GAe SES*GA
1.70 (1.37-2.11)*** 1.36 (1.09-1.71)**
1.31 (1.06-1.62)* 1.49 (1.18-1.89)***
1.09 (0.86-1.37) 1.16 (0.91-1.48)
1.37 (1.13-1.65)*** 1.30 (1.07-1.59)**
1.85 (1.44-2.36)*** 1.30 (1.02-1.66)*
1.49 (1.16-1.92)*** 1.34 (1.02-1.74)*
1.67 (1.34-2.07)*** 1.32 (1.05-1.65)*
1.28 (1.03-1.58)* 1.47 (1.16-1.86)***
1.07 (0.85-1.36) 1.16 (0.91-1.47)
1.34 (1.11-1.62)*** 1.27 (1.04-1.56)*
1.82 (1.42 to 2.33)*** 1.24 (0.97 to 1.60)
1.47 (1.14-1.88)*** 1.30 (0.99-1.69)
1.67 (1.27-2.20)*** 1.32 (0.96-1.81) 0.99 (0.71-1.40)
1.24 (0.92-1.67) 1.42 (1.05-1.93)* 1.06 (0.73-1.53)
1.01 (0.74-1.40) 1.10 (0.80-1.50) 1.12 (0.74-1.68)
1.57 (1.24-1.98)*** 1.53 (1.18-2.00)*** 0.73 (0.55-0.97)*
1.76 (1.30-2.37)*** 1.18 (0.82-1.69) 1.09 (0.75-1.58)
1.58 (1.16-2.14)*** 1.43 (1.00-2.05) 0.86 (0.59-1.25)
1.62 (1.30-2.03)*** 1.34 (1.05-1.69)*
1.30 (1.05-1.62)* 1.44 (1.13-1.85)***
1.09 (0.86-1.38) 1.14 (0.89-1.46)
1.50 (1.18-1.90)*** 1.60 (1.22-2.10)*** 0.73 (0.55-0.98)*
1.79 (1.39-2.30)*** 1.29 (1.00-1.66)
1.33 (1.03-1.72)* 1.36 (1.03-1.80)*
a Model 1: assessing the effects of socioeconomic status (SES) and decreasing gestational age (GA) in a multivariate model.
b Model 2: assessing potentially synergistic effects of SES and GA, by adding the SES*GA interaction to Model 1.
c Model 3: adjusting Model 1 (Model 2 for communication problems) for gender, number of siblings, and maternal age.
d Decreasing SES: the odds ratio (OR) represents the effect of every standard deviation (SD) decrease in SES with respect to the highest SES value (reference). On the standardized SES scale 260 children had a SES score < 1 SD below the mean (low SES), of which 6 children (2.3%) had a SES score < 2 SD below the mean. e Decreasing GA: the OR represents the effect of a one SD (i.e. ~ 3 weeks) decrease in GA compared to the highest GA value. Mean GA was 36 weeks.
Levels of significance: * indicates P < .05, ** indicates P < .01, and *** indicates P < .005 DISCUSSION
Our study showed that moderate prematurity and low SES are separate risk factors with multiplicative effects on developmental delay in early childhood. Only effects on communication skills were less than multiplicative. Decreasing SES and decreasing GA were both associated with increased risks of delay in overall development and delay in domains fine motor, communication, and personal-
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