Univerisdade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
The University of Queensland. School of Human Movement and Nutrition Sciences. Brisbane, Queensland, Australia.
Rev Saude Publica. 2021 Jun 25;55:32. doi: 10.11606/s1518-8787.2021055002958. eCollection 2021.
To investigate the association between child care attendance since birth and development in two-years-old Brazilian children.
The study used longitudinal data from the 2015 Pelotas Birth Cohort. The childhood development (cognitive, fine and gross motor skills, and language) at two-years-old children was assessed using INTER-NDA (INTERGROWTH-21st Neurodevelopment Assessment). The child care attendance was measured at ages one and two years and categorized as: a) never attended child care; b) attended some child care (one or two years); and c) always attended child care (one and two years). Demographic, socioeconomic, health, and child stimulation variables were considered as confounders. Crude and adjusted analyses of child care attendance and development were carried out using linear regression.
Out of the 3,870 infants included in the analyses, around 1/3 attended center-based child care. In crude analyses, attending center-based child care was associated with positive developmental outcomes, except in motor domains. In adjusted analyses, compared to those children that have never attended child care, children who did attend presented higher scores for cognitive development (always in child care: β: 2.44, 95%CI: 0.83-4.05; some child care: β: 1.35, 95%CI: 0.17-2.53).
This study suggests that center-based child care may help improve child cognitive development in the Brazilian context. Furthermore, the association was higher for early and continued attendance. Considering the low prevalence of children in external care, it is recommended to improve child care opportunities in early childhood.
研究自出生起就入托与巴西儿童两岁时发育之间的关系。
本研究使用了 2015 年佩洛塔斯出生队列的纵向数据。通过 INTER-NDA（INTERGROWTH-21 神经发育评估）评估两岁儿童的儿童发育（认知、精细和粗大运动技能以及语言）。托育服务的参与情况在一岁和两岁时进行测量，并分为：a）从未入托；b）入托一段时间（一到两年）；c）一直入托（一到两年）。将人口统计学、社会经济、健康和儿童刺激变量视为混杂因素。采用线性回归对托育服务参与情况和发育进行了未经调整和调整后的分析。
在纳入分析的 3870 名婴儿中，约有 1/3 的婴儿参加了以中心为基础的日托。在未经调整的分析中，参加以中心为基础的日托与积极的发展结果相关，除了在运动领域。在调整后的分析中，与从未参加过托育服务的儿童相比，参加过托育服务的儿童在认知发展方面的得分更高（一直参加：β：2.44，95%CI：0.83-4.05；部分参加：β：1.35，95%CI：0.17-2.53）。
本研究表明，以中心为基础的托育服务可能有助于改善巴西儿童的认知发展。此外，早期和持续的参与与更高的关联度相关。考虑到外部照顾的儿童比例较低，建议在幼儿期增加儿童照顾机会。
