Accounting for social and environmental drivers of neurodevelopment: lessons from a pilot study in a pediatric Colombian cohort

考虑社会和环境因素对神经发育的影响:一项针对哥伦比亚儿童队列的试点研究的启示

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Abstract

BACKGROUND: Child neurodevelopment is shaped by complex social, environmental, and biological factors. Few studies have characterized these factors in Latin American populations. We aimed to evaluate the impact of social and environmental factors on neurodevelopmental outcomes in 5-6-year-old children from three geographic locations in Colombia. METHODS: Our pilot, cross-sectional study included 105 typically developing Colombian children from two urban cities and one rural municipality. Measures assessed domains of IQ (Wechsler Preschool and Primary Scale of Intelligence-WPPSI), executive functioning, psychosocial functioning, and a range of home environmental factors. We compared outcomes across locations and the impact of covariates using linear regression models. RESULTS: Including covariates, adjusted mean WPPSI IQ was significantly lower in children living in a rural town (80.41 ± 2.07) compared to either city (96.30 ± 2.76; 91.69 ± 2.90). Maternal education, location, dietary diversity, and home resources explained 46% of the variance in IQ. Outcomes in other domains were significantly different, but functioning was all within age expectations across groups. CONCLUSION: Significant disparities in cognitive and other outcomes exist among typically developing Colombian children, influenced by location, maternal education, and home resources. Future research should ensure well-matched control populations and use culturally appropriate, validated assessments to minimize social, cultural, and environmental confounding. IMPACT: Maternal education, dietary diversity, total home resources, and location account for approximately 50% of the neurodevelopmental variability of children from urban and rural Colombian cohorts. Typically developing children from a rural community in Colombia have a lower Full-Scale IQ than peers from urban cities, even after including multiple covariates. Future research should continue to study the multiple factors that impact neurodevelopment, particularly in low- and middle-income countries. Well-matched control populations and the use of culturally appropriate, validated assessments are important to minimize confounding factors in neurodevelopmental outcomes research, as statistical correction is not sufficient to fully account for these differences.

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