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How well can poor child health and development be predicted by data collected in early childhood?
  1. Viviane S Straatmann1,
  2. Anna Pearce2,
  3. Steven Hope3,
  4. Benjamin Barr1,
  5. Margaret Whitehead1,
  6. Catherine Law3,
  7. David Taylor-Robinson1
  1. 1 Department of Public Health and Policy, University of Liverpool, Liverpool, UK
  2. 2 MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
  3. 3 Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
  1. Correspondence to Dr Viviane S Straatmann, Department of Public Health and Policy, University of Liverpool, Liverpool L69 3GB, UK; v.schultz-straatmann{at}liv.ac.uk

Abstract

Background Identifying children at risk of poor developmental outcomes remains a challenge, but is important for better targeting children who may benefit from additional support. We explored whether data routinely collected in early life predict which children will have language disability, overweight/obesity or behavioural problems in later childhood.

Methods We used data on 10 262 children from the UK Millennium Cohort Study (MCS) collected at 9 months, 3, and 11 years old. Outcomes assessed at age 11 years were language disability, overweight/obesity and socioemotional behavioural problems. We compared the discriminatory capacity of three models: (1) using data currently routinely collected around the time of birth; (2) Model 1 with additional data routinely collected at 3 years; (3) a statistically selected model developed using a larger set of early year’s risk factors for later child health outcomes, available in the MCS—but not all routinely collected.

Results At age 11, 6.7% of children had language disability, 26.9% overweight/obesity and 8.2% socioemotional behavioural problems. Model discrimination for language disability was moderate in all three models (area under the curve receiver-operator characteristic 0.71, 0.74 and 0.76, respectively). For overweight/obesity, it was poor in model 1 (0.66) and moderate for model 2 (0.73) and model 3 (0.73). Socioemotional behavioural problems were also identified with moderate discrimination in all models (0.71; 0.77; 0.79, respectively).

Conclusion Language disability, socioemotional behavioural problems and overweight/obesity in UK children aged 11 years are common and can be predicted with moderate discrimination using data routinely collected in the first 3 years of life.

  • child health
  • health inequalities
  • public health policy
  • social epidemiology
  • health services

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Footnotes

  • Contributors VSS carried out the statistical analyses, drafted the initial manuscript, reviewed and revised the manuscript. AP and SH participated in the drafting of the initial manuscript, reviewed and revised the manuscript. BB participated in the drafting of the initial manuscript, reviewed and revised the manuscript. MW contributed to the conceptualisation of the study, participated in the drafting of the initial manuscript, reviewed and revised the manuscript. CL conceptualised and designed the study, participated in the drafting of the initial manuscript, reviewed and revised the manuscript. DT-R conceptualised and designed the study, coordinated, drafted the initial manuscript, reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding This work was supported by the UK Public Health Research Consortium (PHRC). The PHRC is funded by the Department of Health and Social Care Policy Research Programme. The views expressed in this paper are those of the authors and do not necessarily reflect those of the Department of Health and Social Care. Information about the wider programme of the PHRC is available from http://phrc.lshtm.ac.uk/. AP is funded by The Wellcome Trust (205412/Z/16/Z), the Medical Research Council (MC_UU_12017/13) and the Scottish Government Chief Scientist Office (SPHSU13). BB is supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Health Research and Care (CLAHRC NWC). The NIHR had no role in the study design, data collection and analysis, decision to publish or preparation of the article. This report is independent research arising from research supported by the NIHR. DTR is funded by the MRC on a Clinician Scientist Fellowship (MR/P008577/1).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Ethical approval for each wave of the MCS was granted by NHS Multicentre Research Ethics Committees. No further ethical approval was required for this secondary analysis of MCS data.

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

  • Data sharing statement All MCS data used inthis analysis are available from UK Data Service, University of Essexand University of Manchester: http://doi.org/10.5255/UKDA-SN-4683-4; http://doi.org/10.5255/UKDA-SN-5350-4; http://doi.org/10.5255/UKDA-SN-7464-3.

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