Abstract
OBJECTIVES: To explore environmental and individual factors that are associated with child development and to investigate whether the strength of these associations differs according to the age of the children. DESIGN: Cross-sectional study. SETTING: This study was part of the LIFE Child study, a large cohort study conducted in Leipzig, Germany. PARTICIPANTS: 778 children aged between 0.5 and 6 years (48.6% girls, mean age=2.67 years). OUTCOME MEASURES: The outcomes were cognitive development, language development, body and hand motor skills, social-emotional development, and tracing skills, measured with a standardised development test. We analysed the associations between development and gestational age, socioeconomic status (SES), sex, behavioural difficulties, siblings, sleep duration, breastfeeding duration and overweight/obesity. We also tested for interactions between these variables and child age or sex. RESULTS: Higher gestational age (b ranging between 0.12 and 0.26) and higher SES (b ranging between 0.08 and 0.21) were associated with better outcomes in almost all developmental domains (all p<0.019). Children with older siblings had improved body and hand motor skills compared with children without older siblings (both b=0.55, all p<0.029). Boys had poorer scores than girls in body and hand motor skills and tracing (b=-0.45, -0.68 and -1.5, all p<0.019). Children with behavioural difficulties had significantly poorer outcomes in most developmental domains. Some of the associations with SES and sex were stronger in older than in younger children. Associations between gestational age and motor development were weaker in older children. We did not find significant associations between child development and sleep duration, breastfeeding duration or overweight/obesity. CONCLUSION: Some factors had a protective, others an adverse effect on development of children under 6 years of age. The effect of SES and sex increased, while the effect of gestational age decreased with age. TRIAL REGISTRATION NUMBER: NCT02550236.