Centro de Pesquisas Epidemiológicas, Universidade Federal de Pelotas, Pelotas, Brazil.
Int J Epidemiol. 2010 Feb;39(1):285-94. doi: 10.1093/ije/dyp272. Epub 2009 Aug 28.
Child health has improved in many developing countries, bringing new challenges, including realization of the children's full physical and intellectual potential. This study explored child development within a birth cohort, its psychosocial determinants and interactions with maternal schooling and economic position.
All children born in Pelotas, Brazil, in 2004, were recruited to a birth cohort study. These children were assessed at birth and at 3, 12 and 24 months of age. In this last assessment involving 3869 children, detailed information on socio-economic and health characteristics was collected. Child development was assessed using the screening version of Battelle's Development Inventory. Five markers of cognitive stimulation and social interaction were recorded and summed to form a score ranging from 0-5. The outcomes studied were mean development score and low performance (less than 10th percentile of the sample).
Child development was strongly associated with socio-economic position, maternal schooling and stimulation. Having been told a story and owning a book were the least frequent markers among children with score 1. These children were 8.3 times more likely to present low performance than those who scored 5. The effect of stimulation was much stronger among children from mothers with a low level of schooling--one additional point added 1.7 on the child's development for children of low-schooling mothers, whereas only 0.6 was added for children of high-schooling mothers.
Our stimulation markers cannot be directly translated into intervention strategies, but strongly suggest that suitably designed cognitive stimulation can have an important effect on children, especially those from mothers with low schooling.
许多发展中国家的儿童健康状况得到了改善，这带来了新的挑战，包括实现儿童的身体和智力潜能。本研究探讨了在一个出生队列中儿童的发展、其社会心理决定因素以及与母亲教育程度和经济地位的相互作用。
所有 2004 年在巴西佩洛塔斯出生的儿童都被招募到一个出生队列研究中。这些儿童在出生时和 3、12 和 24 个月时进行评估。在涉及 3869 名儿童的最后一次评估中，收集了详细的社会经济和健康特征信息。儿童发展使用 Battelle 发展清单的筛查版本进行评估。记录了 5 个认知刺激和社会互动的标志物，并将其相加形成一个 0-5 分的分数。研究的结果是平均发展得分和低表现（低于样本的第 10 百分位）。
儿童发展与社会经济地位、母亲教育程度和刺激密切相关。有故事和拥有一本书是得分 1 的儿童中最不常见的标志物。与得分 5 的儿童相比，这些儿童表现出低表现的可能性高 8.3 倍。对于受教育程度较低的母亲的孩子来说，刺激的效果要强得多——对于受教育程度较低的母亲的孩子来说，每增加一个点，孩子的发展就会增加 1.7，而对于受教育程度较高的母亲的孩子来说，只增加 0.6。
我们的刺激标志物不能直接转化为干预策略，但强烈表明，经过适当设计的认知刺激对儿童，尤其是那些来自受教育程度较低的母亲的儿童，可能会产生重要影响。
