Studies suggest that both pre- and postnatal factors are predictors of age of attaining milestones in infancy. However, no studies evaluate the comparative strength of these predictors and the amount of the variance in development they explain. This study aimed to conduct a systematic evaluation of a broad selection of possible predictors of age at milestone attainment and to identify factors that explain significant inter-individual variance. Mothers of 5765 children of the Copenhagen Perinatal Cohort (1959–61) recorded 12 developmental milestones prospectively during the child’s first year of life. Information on possible predictors was collected during pregnancy and at follow-up and was categorized into the domains: Family background, Pregnancy and delivery, Postnatal influences, and Postnatal growth. The domain Pregnancy and delivery contributed most of the explained variance in Overall mean of milestones (14.4%), with especially gestational age (β = −0.15; p ≤ 0.001) and birth weight (β = −0.16; p ≤ 0.001) being important predictors.
Conclusion: Several individual factors, especially gestational age, birth weight, breastfeeding, having lived in a full-time institution, and weight and head increase in the first year, were significantly associated with milestone attainment in the first year of life. Variables within the domain of Pregnancy and delivery explained the largest proportion of variance in milestone attainment compared to the other domains.
What is known:
• Younger age at attainment of motor developmental milestones positively predicts cognitive outcomes in adulthood.
• Both pre- and postnatal factors have been associated with age of attaining milestones in infancy.
What is new:
• First study to provide a systematic evaluation of a broad selection of predictors of infant milestone attainment.
• Variables within the domain of Pregnancy and delivery, especially gestational age and birth weight, explained the largest proportion of variance in milestone attainment.
• The variance explained by the predictors decreased time-dependently with later milestones.
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We are indebted to the infants and parents for taking part in this study. The authors acknowledge the crucial role of AL Villumsen and B Zachau-Christiansen in the establishment of the Copenhagen Perinatal Cohort and thank the Steering Committee for the Copenhagen Perinatal Cohort for the permission to conduct this study. We acknowledge the contribution of Sarah Jegsmark Gibbons for her assistance in searching through the scientific literature. Finally, the authors thank Esther Mortensen for her critical comments and help with the manuscript.
Trine Flensborg-Madsen conceptualized and designed the study, analyzed the data, performed the statistical analyses, drafted the initial manuscript, and wrote the final manuscript with contribution from the co-author.
Erik Lykke Mortensen conceptualized and designed the study, reviewed and revised the initial manuscript, and approved the final manuscript as submitted.
This study was supported by a grant from the IMK Almene Fond to Trine Flensborg-Madsen. In addition, the study was supported by grants HD-17655 and HD-20263 from the National Institute of Child Health and Human Development to June Reinisch, a grant from the National Institute of Drug Abuse to June Reinisch, a grant 9700093 from the Danish Research Council to Erik Lykke Mortensen, and grant 1400/2-4-1997 from the Danish National Board of Health to Erik Lykke Mortensen.
Conflict of interest
The authors declare that they have no competing interests.
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
Communicated by Mario Bianchetti
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Flensborg-Madsen, T., Mortensen, E.L. Predictors of motor developmental milestones during the first year of life. Eur J Pediatr 176, 109–119 (2017). https://doi.org/10.1007/s00431-016-2817-4
- Infant development
- Motor developmental milestones
- Postnatal factors
- Birth cohort
- Longitudinal study