Risk Factors for Deficits in Early Cognitive Development

  • Sarah H. Broman
Part of the Environmental Science Research book series (ESRH, volume 21)


The current emphasis on risk assessment, a methodology introduced in the early fifties (1), has been attributed to a decreased public tolerance for exposure to potentially harmful events, particularly if the exposure is perceived as involuntary and widespread (2). Efforts to identify risk factors are certainly not new, nor have they been unproductive. What has become increasingly urgent is the need to carry out the complex tasks involved in quantifying risks so that their relative importance can be evaluated. It is well-recognized that all segments of the population are not at equal risk following similar exposure to an injurious event. Examples of susceptible subpopulations are pregnant women, infants, and young children. In this paper, methods of identifying and evaluating risk factors for cognitive deficits in infancy and early childhood are illustrated by findings from a large-scale longitudinal study of the developmental consequences of complications in pregnancy and the perinatal period. Between 1959 and 1974, the offspring from 53,043 pregnancies were followed from gestation through eight years of age in the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke. Women in the study were selected by site of prenatal care. Abnormal outcomes of particular interest were cerebral palsy, mental retardation, congenital malformations, and learning disorders. Causes of perinatal death and prematurity were also investigated, as were factors related to physical and cognitive growth. The goals of the Perinatal Project were heavily influenced by the work of Lilienfeld, and Knobloch and Pasamanick and colleagues who carried out a series of retrospective studies to investigate the concept of a continuum of reproductive casualty, an hypothesis that complications in pregnancy and the perinatal period can produce a spectrum of abnormalities ranging from fetal or neonatal death through severe to mild neurological deficit (3,4).


Cerebral Palsy Cognitive Deficit Fetal Alcohol Syndrome Discriminant Function Analysis Severe Mental Retardation 
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  1. 1.
    Lilienfeld, A.M.: Advances in quantitative methods in epidemiology. Public Health Rep., 95:462 (1980)PubMedGoogle Scholar
  2. 2.
    The risks of assessing risks. Br. Med. J., 281:1374 (1980)Google Scholar
  3. 3.
    Lilienfeld, A.M. and Pasamanick, B.: The association of maternal and fetal factors with the development of cerebral palsy and epilepsy. Am. J. Obstet. Gynecol., 70:93 (1955)PubMedGoogle Scholar
  4. 4.
    Nelson, K.B: The ‘continuum of reproductive casualty.’ In Clinics in Developmental Medicine No. 27, Studies in Infancy, Ed. by R. MacKeith and M. Bax. Spastics International Medical Publications, London, p. 100 (1968)Google Scholar
  5. 5.
    Caputo, D.V. and Mandell, W.: Consequences of low birthweight. Dev. Psychol., 3:363 (1970)CrossRefGoogle Scholar
  6. 6.
    Court, S.D.M.: Context and priorities for paediatric research in the eighties. Pediatr. Res., 14:1290 (1980)PubMedCrossRefGoogle Scholar
  7. 7.
    Broman, S.H.: Birthweight, infant development and preschool IQ. Unpublished manuscript (1973)Google Scholar
  8. 8.
    Little, W.J.: On the influence of abnormal parturition, difficult labor, premature birth, and asphyxia neonatorum on the mental and physical condition of the child, especially in relation to deformities. Trans. Obstet. Soc. London, 3:293 (1862)Google Scholar
  9. 9.
    Gottfried, A.W.: Intellectual consequences of perinatal anoxia. Psychol. Bull., 80:231 (1973)PubMedCrossRefGoogle Scholar
  10. 10.
    Broman, S.H.: Perinatal anoxia and cognitive development in early childhood. Chapt. 3 in Infants Born at Risk, Ed. by T. Field. Spectrum Publications, Jamaica, New York, p. 29 (1979)Google Scholar
  11. 11.
    American Academy of Pediatrics, Committee on Drugs. Effect of medication during labor and delivery on infant outcome. Pediatrics, 62:402 (1978)Google Scholar
  12. 12.
    Broman, S.H. and Brackbill, Y.: Obstetric medication and early development. In T. Sedick (Chair), The international year of the child: A retrospective consideration of perinatal factors influencing pregnancy outcome and development. Symposium presented at the annual meeting of the American Association For the Advancement of Science, San Francisco (1980)Google Scholar
  13. 13.
    Broman, S.H.: Perinatal antecedents of severe mental retardation in school-age children. Paper presented at the 86th annual convention of the American Psychological Association, Toronto (1978)Google Scholar
  14. 14.
    Leviton, A. and Gilles, F.: Maternal urinary-tract infections and fetal leukoencephalopathy. N. Engl. J. Med., 301:661 (1979)PubMedGoogle Scholar
  15. 15.
    Naeye, R.L.: Causes of the exesssive rates of perinatal mortality and prematurity in pregnancies complicated by maternal urinary-tract infections. N. Engl. J. Med., 300:819 (1979)PubMedCrossRefGoogle Scholar
  16. 16.
    Leviton, A., Gilles, F.H., and Dooling E.: Epidemiology of the perinatal telencephalic leukoencephalopathy characterized by hypertrophic astrocytes and amphophilic globules. Neurology (Minneap.), 29:571 (1979)Google Scholar
  17. 17.
    Broman, S.H.: Early development and family characteristics of low achievers: A multivariate analysis. Paper presented at the Scientific Research Workshop on Neurological Aspects of Learning and Behavior Disorders, 15th International Conference of the Association for Children with Learning Disabilities, Kansas City, Mo. (1978)Google Scholar
  18. 18.
    Minskoff, J.G.: Differential approaches to prevalence estimates of learning disabilities. Ann. N.Y. Acad. Sci., 205:139 (1973)PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1981

Authors and Affiliations

  • Sarah H. Broman
    • 1
  1. 1.National Institute of Neurological and Communicative Disorders and StrokeBethesdaUSA

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