ImportanceDefining basic psychosocial resources to facilitate thriving in the first year of life could tangibly inform policy and enhance child development worldwide.ObjectiveTo determine if key environmental supports measured as a thrive factor (T-factor) in the first year of life positively impact brain, cognitive, and socioemotional outcomes through age 3.Design, Setting, and ParticipantsThis prospective longitudinal cohort study took place at a Midwestern academic medical center from 2017 through 2022. Participants included singleton offspring oversampled for those facing poverty, without birth complications, congenital anomalies, or in utero substance exposures (except cigarettes and marijuana) ascertained prenatally and followed up prospectively for the first 3 years of life. Data were analyzed from March 9, 2023, through January 3, 2024.ExposuresVarying levels of prenatal social disadvantage advantage and a T-factor composed of environmental stimulation, nutrition, neighborhood safety, positive caregiving, and child sleep.Main outcomes & measuresGray and white matter brain volumes and cortical folding at ages 2 and 3 years, cognitive and language abilities at age 3 years measured by the Bayley-III, and internalizing and externalizing symptoms at age 2 years measured by the Infant-Toddler Social and Emotional Assessment.ResultsThe T-factor was positively associated with child cognitive abilities (β = 0.33; 95% CI, 0.14-0.52), controlling key variables including prenatal social disadvantage (PSD) and maternal cognitive abilities. The T-factor was associated with child language (β = 0.36; 95% CI, 0.24-0.49), but not after covarying for PSD. The association of the T-factor with child cognitive and language abilities was moderated by PSD (β = −0.32; 95% CI, −0.48 to −0.15 and β = −0.36; 95% CI, −0.52 to −0.20, respectively). Increases in the T-factor were positively associated with these outcomes, but only for children at the mean and 1 SD below the mean of PSD. The T-factor was negatively associated with child externalizing and internalizing symptoms over and above PSD and other covariates (β = −0.30; 95% CI, −0.52 to −0.08 and β = −0.32; 95% CI, −0.55 to −0.09, respectively). Increasing T-factor scores were associated with decreases in internalizing symptoms, but only for children with PSD 1 SD above the mean. The T-factor was positively associated with child cortical gray matter above PSD and other covariates (β = 0.29; 95% CI, 0.04-0.54), with no interaction between PSD and T-factor.Conclusions and RelevanceFindings from this study suggest that key aspects of the psychosocial environment in the first year impact critical developmental outcomes including cognitive, brain, and socioemotional development at age 3 years. This suggests that environmental resources and enhancement in the first year of life may facilitate every infant’s ability to thrive, setting the stage for a more positive developmental trajectory.

中文翻译：

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生命第一年积极大脑和认知发展的基本环境支持


重要性定义基本社会心理资源以促进生命第一年的成长可以切实为政策提供信息并促进全世界儿童的发展。目的确定生命第一年作为成长因素（T 因子）衡量的关键环境支持是否对大脑、认知能力产生积极影响3. 设计、环境和参与者 这项前瞻性纵向队列研究于 2017 年至 2022 年在中西部学术医疗中心进行。参与者包括对那些面临贫困、没有出生并发症、先天性异常或患有产前确定子宫内物质暴露（香烟和大麻除外），并在生命的前 3 年进行前瞻性随访。数据分析时间为 2023 年 3 月 9 日至 2024 年 1 月 3 日。暴露不同水平的产前社会劣势优势和由环境刺激、营养、邻里安全、积极护理和儿童睡眠组成的 T 因素。测量 2 岁和 3 岁时的灰质和白质脑容量和皮质折叠，通过 Bayley-III 测量 3 岁时的认知和语言能力，通过婴幼儿社会和情感评估测量 2 岁时的内化和外化症状结果 T 因子与儿童认知能力呈正相关（β = 0.33；95% CI，0.14-0.52），控制包括产前社会劣势 (PSD) 和母亲认知能力在内的关键变量。 T 因子与儿童语言相关（β = 0.36；95% CI，0.24-0.49），但在 PSD 共变后则不相关。 T 因子与儿童认知和语言能力的关联由 PSD 调节（β = -0.32；95% CI，-0.48至-0.15且β=-0.36； 95% CI，分别为-0.52 至-0.20）。 T 因子的增加与这些结果呈正相关，但仅限于处于 PSD 平均值和低于 PSD 平均值 1 SD 的儿童。 T 因子与儿童外化和内化症状呈负相关（β = -0.30；95% CI，-0.52 至 -0.08；β = -0.32；95% CI，-0.55 至 -0.09） ， 分别）。 T 因子得分的增加与内化症状的减少相关，但仅限于 PSD 高于平均值 1 SD 的儿童。 T 因子与高于 PSD 和其他协变量的儿童皮质灰质呈正相关（β = 0.29；95% CI，0.04-0.54），PSD 和 T 因子之间没有交互作用。本研究的结论和相关性结果表明，关键第一年的社会心理环境会影响关键的发展结果，包括三岁时的认知、大脑和社会情感发展。这表明，生命第一年的环境资源和增强可能会促进每个婴儿的成长能力，为更积极的发展轨迹奠定基础。