Interpregnancy intervals and child development at age 5: A population data linkage study

Abstract

Objective To investigate the associations between interpregnancy intervals (IPIs) and developmental vulnerability in children's first year of full-time school (age 5). Design Retrospective cohort study using logistic regression. ORs were estimated for associations with IPIs with adjustment for child, parent and community sociodemographic variables. Setting Western Australia (WA), 2002-2015. Participants 34 574 WA born singletons with a 2009, 2012 or 2015 Australian Early Development Census (AEDC) record. Main outcome measure The AEDC measures child development across five domains; Physical Health and Wellbeing, Social Competence, Emotional Maturity, Language and Cognitive Skills (school-based) and Communication Skills and General Knowledge. Children with scores <10th percentile were classified as developmentally vulnerable on, one or more domains (DV1), or two or more domains (DV2). Results 22.8% and 11.5% of children were classified as DV1 and DV2, respectively. In the adjusted models (relative to the reference category, IPIs of 18-23 months), IPIs of <6 months were associated with an increased risk of children being classified as DV1 (adjusted OR (aOR) 1.17, 95% CI 1.08 to 1.34), DV2 (aOR 1.31, 95% CI 1.10 to 1.54) and an increased risk of developmental vulnerability for the domains of Physical Health and Wellbeing (aOR 1.25, 95% CI 1.06 to 1.48) and Emotional Maturity (aOR 1.36, 95% CI 1.12 to 1.66). All IPIs longer than the reference category were associated with and increased risk of children being classified as DV1 and DV2 (aOR >1.15). IPIs of 60-119 months and ≥120 months, were associated with an increased risk of developmental vulnerability on each of the five AEDC domains, with greater odds for each domain for the longer IPI category. Conclusions IPIs showed independent J-shaped relationships with developmental vulnerability, with short (<6 months) and longer (≥24 months) associated with increased risks of developmental vulnerability.