Abstract
Background
Economic development and rapid urbanisation in China has caused parents to migrate to urban cities for jobs and to leave their children behind. The population of left-behind children has grown and requires attention, as early child development might be negatively affected by the lack of parental interaction. We therefore aimed to assess the specific influence of migrant mothers on early child development, especially on social–emotional problems.
Methods
We did a cross-sectional study obtaining data from eight counties of central and western rural China. We included children of either sex who were aged 59 months or less, and assessed their development status using the Chinese edition of the Ages and Stages Questionnaires: Social-Emotional. The primary measures were the association between being left behind by migrant mothers and developmental problems in various domains (communication, gross motor, fine motor, problem solving, and personal–social competence). We evaluated this association using multivariate logistic regressions while adjusting for sociodemographic (age, sex, education level of caregivers, and birth order), socioeconomic (household income), and perinatal (gestational age, birthweight, and delivery method) covariates. This study was approved by the Ethics Committee of Peking University Health Science Center. All caregivers gave their written permission or fingerprint (for illiterate caregivers) for their children's involvement in the survey.
Findings
Between Oct 5, 2016, and Jan 31, 2017, we assessed 1927 children. No significant associations were observed after adjusting for potential confounders between being left behind by migrant mothers and the following developmental measures: overall suspected development delay and development delay in domains of communication, gross motor, fine motor, problem solving, and personal–social competence. Children left behind by migrant mothers were more likely to have social–emotional problems than those living with their own mothers (odds ratio [OR] 1·45, 95% CI 1·03–2·06). Additionally, children aged 24–59 months (OR 1·88, 95% CI 1·20–2·95), girls (2·74, 1·56–4·82), and the second and later child in the family (1·85, 1·18–2·91) are all factors that could increase the odds of social–emotional problems in those who were left behind by migrant mothers.
Interpretation
This study suggested that although children left behind by migrant mothers presented similarly with their peers living with their mothers on development, they were more likely to have social–emotional problems. Interventions should pay more attention to children who are girls, aged 24–59 months, and the second and later child of the family.