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  • Publication # 13-RA007

Short spacing between children boosts the older child’s risk of behavioral and cognitive problems

Child/Adolescent Health

Closely spaced births are associated with a range of adverse health and social and economic consequences for women, ranging from poor maternal nutritional status to reduced employment and education, especially for adolescent mothers. Now a new study reveals that giving birth to another child within 24 months of the previous one raises the older child’s risk of behavioral and cognitive problems. Johns Hopkins University School of Medicine researchers examined the impact of these rapid repeat births (RRBs) on the next older child in the family, whom they termed the index child. As part of a large randomized trial of the Hawaii Healthy Start Program, families were screened for risk of child maltreatment. At-risk families who spoke English and had no current involvement with Child Protective Services (CPS) were randomly assigned to either the Hawaii Healthy Start program or a control group. For these analyses, 658 families were included.

The researchers compared index children in families with RRBs and families without RRBs in terms of parenting behaviors at index child age 2, age 3, and first grade, as well as child behavior and development. They found that, controlling for maternal age, number of births, and intervention group status, the women who had an RRB were 50 percent more likely to report neglecting their index child, and 80 percent more likely to have a substantiated report from CPS. Index children of mothers with an RRB exhibited externalizing behavior twice as often as those whose mothers did not have an RRB. The index children of RRB mothers had lower scores for communication and socialization adaptive behaviors, and had significantly lower verbal reasoning and short-term memory in first grade. The researchers screened 5,810 families, who had a birth on the island of Oahu between November 1994 through December 1995, for being at-risk of child maltreatment. The data analysis for this study was funded in part by AHRQ (T32 HS17596).

More details are in "Relationship between birth spacing, child maltreatment, and child behavior and development outcomes among at-risk families" by Sarah Shea Crowne, Ph.D., Kay Gonsalves, M.S.P.H., Lori Burrell, M.A., and others in the October 2012 Maternal and Child Health Journal 16(7), pp. 1413-1420.


Page last reviewed April 2013
Internet Citation: Short spacing between children boosts the older child’s risk of behavioral and cognitive problems: Child/Adolescent Health. April 2013. Agency for Healthcare Research and Quality, Rockville, MD.


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