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Associations between clusters of early life risk factors and developmental vulnerability at age 5: a retrospective cohort study using population-wide linkage of administrative data in Tasmania, Australia
  1. Catherine Louise Taylor1,2,
  2. Daniel Christensen1,
  3. Joel Stafford1,
  4. Alison Venn3,
  5. David Preen4,
  6. Stephen Rade Zubrick1,2
  1. 1Telethon Kids Institute, Nedlands, Western Australia, Australia
  2. 2Centre for Child Health Research, The University of Western Australia, Crawley, Western Australia, Australia
  3. 3Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
  4. 4School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
  1. Correspondence to Professor Catherine Louise Taylor; cate.taylor{at}telethonkids.org.au

Abstract

Objective Early childhood is a critical time to address risk factors associated with developmental vulnerability. This study investigated the associations between clusters of early life risk factors and developmental vulnerability in children’s first year of full-time school at age 5.

Design A retrospective cohort study.

Setting Population-wide linkage of administrative data records for children born in Tasmania, Australia in 2008–2010.

Participants The cohort comprised 5440 children born in Tasmania in 2008–2010, with a Tasmanian 2015 Australian Early Development Census (AEDC) record and a Tasmanian Perinatal Collection record.

Outcome measure The AEDC is a national measure of child development across five domains: physical health and well-being, social competence, emotional maturity, language and cognitive skills (school-based), and communication skills and general knowledge. Children who scored below the 10th percentile on one or more AEDC domains were classified as developmentally vulnerable. Children with special needs are not included in the AEDC results.

Results Latent class analysis identified five clusters of risk factors: low risks (65% of children), sociodemographic and health behaviour risks (24%), teenage mother and sociodemographic risks (6%), birth risks (3%), and birth, sociodemographic and health behaviour risks (2%). In this sample population, 20% of children were classified as developmentally vulnerable, but the proportion varied substantially by latent class. Logistic regression showed increased odds of developmental vulnerability associated with sociodemographic and health behaviour risks (OR 2.26, 95% CI 1.91 to 2.68, p<0.001), teenage mother and sociodemographic risks (OR 2.01, 95% CI 1.50 to 2.69, p<0.001), and birth, sociodemographic and health behaviour risks (OR 3.29, 95% CI 2.10 to 5.16. p<0.001), but not birth risks (OR 1.34, 95% CI 0.88 to 2.03, p=0.1649), relative to the reference group.

Conclusions The patterning of risks across the five groups invites consideration of multisectoral policies and services to address complex clusters of risk factors associated with developmental vulnerability.

  • community child health
  • public health
  • epidemiology
http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors CLT, SRZ and AV conceived of the paper. CLT, SRZ, AV, DC, DP and JS contributed to the study design. DC and JS undertook the analyses. CLT, SRZ, AV, DC, DP and JS contributed to the interpretation of the results and writing of the paper. CLT, SRZ, AV, DC, DP and JS approved the final manuscript.

  • Funding This study was supported by a Partnership Project grant from the National Health and Medical Research Council Australia (1115891) and the Tasmanian Department of Education, Department of Health, and Department of Premier and Cabinet. CLT, SRZ and DC are supported by the Australian Research Council Centre of Excellence for Children and Families over the Life Course (CE140100027).

  • Competing interests None declared.

  • Patient and public involvement statement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval Approval to conduct this study was obtained from the Tasmanian Health and Medical Research Ethics Committee (H0016203).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. The linked administrative data are owned by the government departments that approved the linkage and use of the data for this study. Use of the study data is restricted to named researchers. The current Human Research Ethics Committee approval was obtained for public sharing and presentation of data at the group level only, meaning the data used in this study cannot be shared by the authors. Collaborative research may be conducted according to the ethical requirements and relevant privacy legislations. Potential collaborators should contact the authors (CLT or AV) with their expression of interest. The steps involved in seeking permission for linkage and use of the data used in this study are the same for all researchers.