Submission ID 131947
| Issue/Objective | The first 1000 days of life (from conception to a child's second birthday) represent a critical developmental period during which exposure to vulnerability factors (e.g. precarious financial situation, social isolation, and poor maternal mental health) can shape long-term health. We estimated the prevalence of exposure to vulnerability factors during this period and examined their cumulative association with early childhood development in Québec. This work contributes evidence to accelerate efforts addressing the upstream root causes of inequities that begin before birth and continue thereafter. |
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| Methodology/Approach | Data from the Québec Longitudinal Study of Child Development 2nd Ed (QLSCD2), a population-based birth cohort (n=4,703) of children born in 2020-2021 and followed annually were analyzed. Exposure to 10 vulnerability factors were assessed at Waves 1 (5 months) and 2 (17 months): precarious financial situation, low maternal education, young maternal age, social isolation, poor maternal mental health, recent immigration, lone parenthood, exposure to violence, relationship instability, and an unwanted pregnancy. These were summarized as a cumulative vulnerability factor score. Child development was assessed at Wave 3 (29 months) using the Ages and Stages Questionnaire (ASQ-3). Weighted descriptive analyses estimated prevalence and multivariable logistic regressions estimated associations between cumulative exposure to vulnerability and low ASQ-3 (<1 SD below the mean). |
| Results | Among children with outcome data (n=3,589), 54.8% were exposed to at least one vulnerability factor and 23.0% to ≥2. Precarious financial situation was the most common factor (27.3%), followed by poor maternal mental health (18.0%), and recent maternal immigration (13.9%). Compared to children with no exposure, those with one (OR 1.74, 95% CI: 1.59-1.89), two (OR 2.57, 95% CI: 2.35-2.83), or ≥3 vulnerability factors (OR 3.60, 95% CI: 3.22, 4.02) had progressively higher odds of low ASQ-3 scores. Associations were observed across all domains and were strongest for personal-social and problem-solving outcomes. |
| Discussion/Conclusion | Exposure to cumulative vulnerability in early life is common in Québec and is associated with developmental risk in a dose-response manner. Findings underscore the importance of upstream social policies that address the root causes of vulnerability, combined with integrated, community-based perinatal care models to reduce inequities from the earliest stages of life. |
| Presenters and Affiliations | Claire Wamboldt McGill University Marilyn N. Ahun McGill University Health Centre Research Institute Lisa Merry Université de Montréal Marie-Christine Harguindéguy-Lincourt La Maison Bleue Andraea Van Hulst McGill University |
