Factors associated with cognitive developmental delay risk in 12-month-old infants.

OBJECTIVE

To identify factors associated with the risk of cognitive developmental delay in 12-month-old infants and provide evidence for early risk screening and intervention.

METHODS

A case-control study was conducted among 762 twelve-month-old children who underwent developmental screening with the Denver Developmental Screening Test (DDST) at Sichuan Provincial Maternity and Child Health Care Hospital from 2024 to 2025. Of these, 381 with suspected or abnormal development were assigned to the case group, and 381 with normal results served as controls. Perinatal, family, and caregiving factors were collected and were analyzed using univariate and multivariate logistic regression.

RESULTS

Cesarean delivery (OR = 1.42, 95% CI: 1.05-1.93), maternal alcohol use during pregnancy (OR = 9.12, 95% CI: 1.09-76.33), pre-pregnancy overweight (OR = 1.62, 95% CI: 1.02-2.58) and obesity (OR = 2.54, 95% CI: 1.08-5.95), inadequate (OR = 4.09, 95% CI: 1.74-9.62) or excessive (OR = 1.59, 95% CI: 1.10-2.29) gestational weight gain, and grandparental caregiving (OR = 1.80, 95% CI: 1.32-2.46) were independent risk factors. Higher paternal education (postgraduate or above; OR = 0.06, 95% CI: 0.01-0.56) and annual household income > 300,000 CNY (OR = 0.31, 95% CI: 0.12-0.80) were protective.

CONCLUSION

Cognitive developmental risk at 12 months was associated with multiple perinatal, familial, and caregiving-related factors. A comprehensive assessment of potentially modifiable factors, including delivery mode, maternal weight status, gestational weight gain, prenatal alcohol exposure, and caregiving arrangements, may help identify infants at increased developmental risk and provide evidence for targeted early prevention and intervention strategies.