Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia.
PLoS One. 2022 May 10;17(5):e0268325. doi: 10.1371/journal.pone.0268325. eCollection 2022.
This study investigated whether the timing of birth of the younger siblings was associated with the risk of the older siblings' developmental vulnerability in early childhood.
Linkage of population-level birth registration, hospital, and perinatal datasets to Australian Early Development Census (AEDC) records (2009-2015), enabled follow-up of a cohort of 32,324 Western Australia born singletons. Children with scores <10th percentile on an individual AEDC domain (Physical Health and Wellbeing; Social Competence; Emotional Maturity; Language and Cognitive Skills (school-based); and Communication Skills and General Knowledge) were classified as developmentally vulnerable. Modified Poisson Regression was used to estimate relative risks (RR) for associations between post-birth interpregnancy intervals (IPIs) and developmental vulnerability.
Relative to post-birth IPIs of 18-23 months, post-birth IPIs of <6 and 6-11 months were associated with an increased risk of children being classified as DV1 (aRR 1.21, 95% CI: 1.11-1.31) and DV2 (aRR 1.31, 95% CI: 1.15-1.49); and DV1 (aRR 1.10, 95% CI: 1.03-1.17) and DV2 (aRR 1.21, 95% CI: 1.09-1.34), respectively. Post-birth IPIs of <6 months were associated with an increased risk on four of the five AEDC domains. Post-birth IPIs of 48-60 months were associated with an increased risk of developmental vulnerability; however, the risk was statistically significant for DV1, DV2 and the domains of Emotional Maturity and Language and Cognitive Skills (school-based).
Developmental vulnerability was associated with having a closely spaced younger sibling (<12 months post-birth IPIs). Optimising birth spacing should be further investigated as a potential means for improving child development outcomes.
本研究旨在探讨年幼兄弟姐妹的出生时间与儿童早期年长兄弟姐妹的发育脆弱风险之间的关系。
通过链接人口级别的出生登记、医院和围产期数据集与澳大利亚早期发展普查（AEDC）记录（2009-2015 年），对西澳大利亚州出生的 32324 名单胎儿童进行了随访。在个体 AEDC 领域（身体健康和幸福感；社交能力；情绪成熟度；语言和认知技能（基于学校）；以及沟通技能和一般知识）得分低于第 10 百分位数的儿童被归类为发育脆弱。使用修正泊松回归估计出生后妊娠间隔（IPI）与发育脆弱性之间的关联的相对风险（RR）。
与出生后 IPI 为 18-23 个月相比，出生后 IPI 小于 6 个月和 6-11 个月与儿童被归类为 DV1（aRR 1.21，95%CI：1.11-1.31）和 DV2（aRR 1.31，95%CI：1.15-1.49）的风险增加相关；以及 DV1（aRR 1.10，95%CI：1.03-1.17）和 DV2（aRR 1.21，95%CI：1.09-1.34）的风险增加相关。出生后 IPI 小于 6 个月与 AEDC 的五个领域中的四个领域的发育脆弱性风险增加相关。出生后 IPI 为 48-60 个月与发育脆弱性风险增加相关；然而，DV1、DV2 以及情绪成熟度和语言与认知技能（基于学校）领域的风险具有统计学意义。
发育脆弱性与年幼兄弟姐妹（出生后 IPI 小于 12 个月）的紧密间隔有关。进一步研究优化生育间隔是否可以作为改善儿童发育结果的潜在手段。
