JMIR Publications

ABSTRACT

Background:

Developmental diversity (DD) challenges traditional disorder classifications that view neurodevelopmental differences as determined by human variations. However, few studies have longitudinally examined DD and the coordinated effects of child and maternal factors on DD.

Objective:

The purpose of this study is to reveal how DD arises by longitudinally examining child/maternal factors from the perinatal period through infancy.

Methods:

A prospective longitudinal observational study including 147 mothers and their children was conducted; data from gestation to 12 months postpartum were obtained. Assessments were performed during prenatal visits (questionnaires and blood collection); delivery (cord blood); and postpartum visits at 1, 6, and 12 months (questionnaires). The Modified Checklist for Autism in Toddlers (M-CHAT) was used to evaluate individual developmental characteristics (IDC). The relationship between the M-CHAT score and other longitudinal variables was assessed using polychoric or polyserial correlation coefficients. L2-regularized logistic regression and SHapley Additive exPlanations (SHAP) were used to predict the M-CHAT score and to determine each feature’s contribution.

Results:

A total of 21 factors (4 prenatal, 3 at birth, and 14 postnatal) showed significant statistical associations with the M-CHAT score (adjusted P-values < .05). The predictive accuracy for the M-CHAT score was satisfactory (area under the receiver operating characteristic curve = .79). Infant sleep status after 6 months of age (nighttime sleep duration, bedtime, and difficulties falling asleep), as well as maternal Kessler Psychological Distress Scale (K6) and Mother-to-Infant Bonding Scale (MIBS) scores after the late gestation, were important predictors.

Conclusions:

Maternal K6 scores, MIBS scores, and poor infant sleep status were predictors of IDC. This study advances the understanding of DD in clinical research. Clinical Trial: The study was registered in a clinical trial registry (UMIN000034837, registered on November 9, 2018) before commencement.