Determinants of Early Child Development

Abstract

Background Early childhood development is shaped by interactions between biological, prenatal, nutritional, and social factors. Evidence regarding their domain-specific associations across ASQ-3 domains remains limited in Eastern Europe. Objectives To examine biological, prenatal, nutritional, and social predictors of developmental outcomes measured with the ASQ-3. Methods This cross-sectional study included 167 full-term Bulgarian children aged 14–42 months. Parents completed age-appropriate ASQ-3 questionnaires and a structured survey on prenatal and family characteristics. Raw ASQ-3 scores were converted into age-standardized Z-scores. Stepwise multiple linear regression analyses were conducted for each domain. Results Longer breastfeeding duration was positively associated with communication, fine motor, and problem-solving outcomes. Prenatal tobacco exposure was associated with lower communication, fine motor, and problem-solving scores. Communication outcomes were additionally associated with residential setting and bilingual home environment. No significant predictors were identified for gross motor development. Conclusions Early developmental domains demonstrate distinct associations with prenatal, nutritional, and social factors.