Multifactorial Predictors of Infant Neurodevelopment at Six Months: A Hierarchical Regression Analysis

Background Early neurodevelopment results from the interaction between biological conditions at birth and the postnatal caregiving environment. Understanding the relative contribution of these factors during early infancy may improve early identification of children at developmental risk. Objective To investigate the influence of biological, familial, and environmental predictors on neurodevelopmental outcomes at six months of age. Methods A cross-sectional study was conducted among 124 healthy term infants aged six months. Neurodevelopment was assessed using the Ages and Stages Questionnaire, Third Edition (ASQ-3), covering five developmental domains: communication, gross motor, fine motor, problem solving, and personal–social development. Predictors were grouped into biological factors (sex, birth weight, gestational age, exclusive breastfeeding, prenatal alcohol exposure), maternal factors (maternal education and early postpartum return to employment), and environmental factors (language environment and duration of language stimulation). Hierarchical multiple regression analyses were performed to evaluate the independent contribution of each predictor group. Results Biological factors demonstrated the strongest and most consistent associations with early developmental outcomes. Birth weight emerged as the most stable predictor , showing significant positive associations with communication, gross motor, problem-solving, and personal–social development. Prenatal alcohol exposure was independently associated with lower personal–social scores. Sex differences were observed in communication outcomes, with female infants demonstrating slightly higher scores. Maternal and environmental factors contributed only modestly to explained variance and were not retained as independent predictors in the final regression models. Conclusion Early neurodevelopment at six months appears to be primarily influenced by biological characteristics at birth , particularly birth weight, while prenatal alcohol exposure represents a specific risk factor for early social development.