TY  - JOUR
AU  - Kato, Daigo
AU  - Okuno, Akiko
AU  - Ishikawa, Tetsuo
AU  - Itakura, Shoji
AU  - Oguchi, Shinji
AU  - Kasahara, Yoshiyuki
AU  - Kanenishi, Kenji
AU  - Kitadai, Yuzo
AU  - Kimura, Yoshitaka
AU  - Shimojo, Naoki
AU  - Nakahara, Kazushige
AU  - Hanai, Akiko
AU  - Hamada, Hiromichi
AU  - Mogami, Haruta
AU  - Morokuma, Seiichi
AU  - Sakurada, Kazuhiro
AU  - Konishi, Yukuo
AU  - Kawakami, Eiryo
PY  - 2025
DA  - 2025/4/4
TI  - Multilevel Factors and Indicators of Atypical Neurodevelopment During Early Infancy in Japan: Prospective, Longitudinal, Observational Study
JO  - JMIR Pediatr Parent
SP  - e58337
VL  - 8
KW  - early developmental signs
KW  - neurodevelopmental screening
KW  - risk factors
KW  - prediction
KW  - early intervention
KW  - longitudinal study
AB  - Background: The early identification of developmental concerns requires understanding individual differences that may represent early signs of neurodevelopmental conditions. However, few studies have longitudinally examined how child and maternal factors interact to shape these early developmental characteristics. Objective: We aim to identify factors from the perinatal to infant periods associated with early developmental characteristics that may precede formal diagnoses and propose a method for evaluating individual differences in neurodevelopmental trajectories. Methods: A prospective longitudinal observational study of 147 mother-child pairs was conducted from gestation to 12 months post partum. Assessments included prenatal questionnaires and blood collection, cord blood at delivery, and postpartum questionnaires at 1, 6, and 12 months. The Modified Checklist for Autism in Toddlers (M-CHAT) was used to evaluate developmental characteristics that might indicate early signs of atypical neurodevelopment. Polychoric or polyserial correlation coefficients assessed relationships between M-CHAT scores and longitudinal variables. L2-regularized logistic regression and Shapley Additive Explanations predicted M-CHAT scores and determined feature contributions. Results: Twenty-one factors (4 prenatal, 3 at birth, and 14 postnatal) showed significant associations with M-CHAT scores (adjusted P values<.05). The predictive accuracy for M-CHAT scores demonstrated reasonable predictive accuracy (area under the receiver operating characteristic curve=0.79). Key predictors included infant sleep status after 6 months (nighttime sleep duration, bedtime, and difficulties falling asleep), maternal Kessler Psychological Distress Scale scores, and Mother-to-Infant Bonding Scale scores after late gestation. Conclusion: Maternal psychological distress, mother-infant bonding, and infant sleep patterns were identified as significant predictors of early developmental characteristics that may indicate emerging developmental concerns. This study advances our understanding of early developmental assessment by providing a novel approach to identifying and evaluating early indicators of atypical neurodevelopment. 
SN  - 2561-6722
UR  - https://pediatrics.jmir.org/2025/1/e58337
UR  - https://doi.org/10.2196/58337
DO  - 10.2196/58337
ID  - info:doi/10.2196/58337
ER  -