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  1. Path E 35% Path A 15% Path C Path B 19% 31% 791 women who participated in the first follow up study were mailed a survey 491 returned the questionnaire (62% participation) 300 did not return the questionnaire • 11 refused to take the survey • 4 were ineligible (2 out of country, 2 had second child in the survey) • 227 did not return the questionnaire • 58 not contactable by phone Prenatal and Early Life Factors that Predict Risk for Developmental Problems: A Longitudinal Cohort Study Suzanne Tough PhD1,2, Jodi Siever MSc3, Karen Benzies4, Shirley Leew5, David Johnston1,6 1Department of Paediatrics, University of Calgary, 2Department of Community Health Sciences, University of Calgary, 3Public Health Innovation and Decision Support, Alberta Health Services, 4Faculty of Nursing, University of Calgary, 5Decision Support Research Team, Alberta Health Services, 6Behavioral Research Unit, Alberta Children’s Hospital Results of Developmental Screening at Age 5 Background Objective Paths on the Parents’ Evaluation of Development Status (PEDS) • Understanding the long term influence of early life events on child development can inform strategies to identify children and families at risk • To describe features of children who screened at high risk of developmental problems at school entry Methods • Mothers (n=791) who had been followed since the prenatal period were mailed a questionnaire when their child was 4-6 years of age. • Primary Outcome • Risk for developmental problems measured using The Parents’ Evaluation of Developmental Status (PEDS) (internal consistency = 0.81; test-retest reliability=0.88; inter-rater reliability=0.88)) • Other Data • Maternal physical and emotional health (SF-8) • Maternal social support (Medical Outcomes Study Social Support Scale) • Parenting sense of competence and morale (Parenting Sense of Competence Scale and Parenting Morale Index) • Parenting supports and resources • Child behaviour, communication, and self-control (Child Social Competence Scale) • Health care utilization and referrals • All participants provided informed consent Selected Predicted Probabilitiesfor screening at high risk for developmental problems on the PEDS (Path A), from the multinomial logistic regression model Key Predictorsfor screening at high risk for developmental problems on the PEDS (Path A) Mother and Child Characteristics Recruitment & Participation Conclusions Recommendations • The findings are best generalized to middle and high income families in urban settings. (About three-quarters of Canadian families with kids under 6 have a comparable income). • Maternal well-being and history of abuse are related to risk for developmental problems at school entry. • These risks factors were similar to those identified when children were 3 years of age, suggesting maternal well-being has a influence on child development through the early part of childhood. • Better understand how women’s well-being during pregnancy and early childhood can be optimized. • Identify women with a history of abuse and determine what strategies can support their well-being and parenting. • Ongoing research and evaluation of such strategies. • Continue to follow-up this cohort to understand the impact of maternal well-being on middle childhood development. Special thanks to Upstart! (formerly the Calgary Children’s Initiative) for their ongoing support of the CPC follow-up work.