Children born after unplanned pregnancies and cognitive development at 3 years: social differentials in the United Kingdom Millennium Cohort.

Abstract

Children born after an unplanned pregnancy have poorer developmental scores. This could arise from less favorable parenting but also could reflect confounding from the socioeconomic circumstances. In a large representative sample in the United Kingdom, the Millennium Cohort Study (2001-2005), cognitive delay at 3 years was explored with the Bracken Assessment. Its association with unplanned pregnancy was studied in logistic models controlling for demographic and socioeconomic characteristics of the family, the child's characteristics, and parenting behavior. Stratification by the mother's educational level (grouped into 3 categories) was explored. Of 12,182 children included in the analysis, 41% were born after a pregnancy reported by the mother to have been a "surprise." Such unplanned pregnancies were associated in univariate analysis with more cognitive delay. Among mothers with a low or middle level of education, this association vanished when socioeconomic circumstances were controlled. Among mothers with a high level of education, the risk of cognitive delay remained significantly and unexplainedly raised after unplanned pregnancies, despite controlling for socioeconomic characteristics and parental behavior. In conclusion, for socially disadvantaged children, having resulted from an unplanned pregnancy does not seem to increase their already disproportionate risk of cognitive delay. Births after unplanned conceptions are mainly a symptom rather than a source of disadvantage.