Contents lists available at ScienceDirect Early Human Development journal homepage: www.elsevier.com/locate/earlhumdev A longitudinal study of antenatal and perinatal risk factors in early childhood cognition: Evidence from Growing Up in New Zealand Denise Neumann a , Sarah E. Herbert a , Elizabeth R. Peterson a,b , Lisa Underwood b,c , Susan M.B. Morton b , Karen E. Waldie a,b, ⁎ a School of Psychology, University of Auckland, Auckland, Private Bag 92019, Auckland, New Zealand b Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Auckland, Private Bag 92019, Auckland, New Zealand c Department of Psychological Medicine, University of Auckland, Auckland, Private Bag 92019, Auckland, New Zealand ARTICLE INFO Keywords: Child cognition Longitudinal Antenatal Perinatal Risk factors ABSTRACT Background: Poor maternal health, disadvantageous exposures during pregnancy and unfavourable perinatal events are associated with adverse trajectories in offspring cognitive development. Aim: To examine longitudinal associations between antenatal maternal, perinatal and maternal health char- acteristics and children's early cognitive development across executive control, motor ability and receptive language domains. Study design, subjects and outcome measures: Analyses comprised interview and observational data from 4587 children and their mothers enrolled in the longitudinal Growing Up in New Zealand cohort study. Children's executive control (Luria hand clap task), motor skills (mothers' report) and receptive language ability (Peabody Picture Vocabulary Test) were assessed at age 4.5 years. Multivariate logistic regression analyses were con- ducted, controlling for sociodemographic factors. Results: Smoking pre- and during pregnancy, no folate intake during first trimester and low birth weight were risk factors for poorer executive control. Perceived stress during pregnancy, no folate intake during first tri- mester and low birth weight were all risk factors for poorer motor ability. Smoking pre-pregnancy, antenatal anxiety and no folate intake during first trimester were risk factors for poorer receptive language ability. Conclusion: Adverse ante- and perinatal environments are associated with poorer executive control, motor and receptive language abilities in early childhood. Improving maternal education and support especially for more disadvantaged mothers during pregnancy may reduce the potential deleterious impact of adverse ante- and perinatal conditions on children's early cognition. 1. Introduction Cognitive inequalities probably begin in utero. The antenatal en- vironment is a critical period for foetal brain development with a variety of risk factors potentially altering or hindering developmental processes which is known as the Developmental Origins of Health and Disease (DOHaD) approach [1,2]. By identifying those conditions, ad- verse factors that may hinder optimal cognitive development and educational life course early on could be prevented more targeted alongside promoting those factors with a beneficial potential for off- spring cognitive functioning. Established research details how foetal exposure to various elements during gestation and the early postnatal period may affect physical and mental health development with persisting consequences [2,3]. There is substantial research on the negative influence of terato- genic exposure, especially alcohol and nicotine, during pregnancy on offspring cognition, i.e. reductions in executive functioning, working memory, verbal ability and motor skills [4,5]. Recent research suggests that not only heavy but any alcohol consumption throughout pregnancy can impact the development of the foetus [6,7]. Likewise, findings have emerged suggesting passive cigarette smoke exposure has similar det- rimental effects as maternal smoking during pregnancy [8]. The link between BMI and offspring cognition is tenuous, with some evidence suggesting that maternal overweight and obesity during pregnancy has detrimental effects on cognitive abilities in offspring [9]. Maternal stress, anxiety and depression are the most commonly https://doi.org/10.1016/j.earlhumdev.2019.04.001 Received 14 February 2019; Received in revised form 31 March 2019; Accepted 1 April 2019 ⁎ Corresponding author at: School of Psychology, University of Auckland, Auckland, Private Bag 92019, Auckland, New Zealand. E-mail addresses: d.neumann@auckland.ac.nz (D. Neumann), sher139@aucklanduni.ac.nz (S.E. Herbert), e.peterson@auckland.ac.nz (E.R. Peterson), l.underwood@auckland.ac.nz (L. Underwood), s.morton@auckland.ac.nz (S.M.B. Morton), k.waldie@auckland.ac.nz (K.E. Waldie). Early Human Development 132 (2019) 45–51 0378-3782/ © 2019 Elsevier B.V. All rights reserved. T