Determinantes precoces da capacidade cognitiva nas crianças aos 6 anos: Coorte de Nascimentos de Pelotas de 2004.

Abstract

Cognitive ability is an important determinant for the child's future performance and the first two years of life are a critical period for brain development. Period may be affected by many factors, biological, social and the environment, taking the children to failure to achieve all their cognitive potential. On the other hand, there are few longitudinal studies and population-based middle and low income countries, and also in the Brazilian context, studying the early determinants of cognitive ability in childhood. Using data from 2004 Pelotas Birth Cohort aimed to identify what are the determinants and early childhood associated with IQ (intellectual quotient) of children at 6 years old. At first glance, the goal was to determine the early life determinants (the perinatal stage and the first year of the child's life) that best predict low cognitive performance at age 6. Based on a predictive modeling strategy were identified as early predictors sex of the child, parents' skin color, number of siblings, maternal and paternal work, family income, maternal education, persons per room, breastfeeding duration, failure to thrive, smoking of parents in pregnancy and maternal perception of the child's health. The model showed good fit and a good discrimination, area under the ROC curve = 0.80 (95% CI 0.79 - 0.82). Later, we investigated the effects of child cognitive stimulation and maternal depression on IQ at six years of age. The results showed that the stimulation had a positive effect on IQ and maternal depression a negative effect on children's IQ. A cumulative effect described for the stimulation of child and maternal depression. The effect of stimulation was different according to levels of maternal education, where it was observed that there is an effect in increasing IQ stimulation on increasing education, from no effect to low-schooling mothers and reaching +0.17 SD IQ for each increment on a stimulation point in mothers with 12 years or more of schooling. Additionally it was proven that part of the maternal education effect was mediated by stimulation of the child. Finally, a comprehensive review of the literature was conducted to identify and summarize the knowledge related to the determinants of cognitive ability in childhood. The findings show that there are few studies in low- and middle-income countries and the major factors identified were related to the socio-economic conditions, the condition of prenatal and perinatal health, growth in children, breastfeeding and the quality of child care and stimulation.