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Sex‐specific associations between umbilical cord blood testosterone levels and language delay in early childhood

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Background:  Preliminary evidence suggests that prenatal testosterone exposure may be associated with language delay. However, no study has examined a large sample of children at multiple time‐points.

Methods:  Umbilical cord blood samples were obtained at 861 births and analysed for bioavailable testosterone (BioT) concentrations. When participating offspring were 1, 2 and 3 years of age, parents of 767 children (males = 395; females = 372) completed the Infant Monitoring Questionnaire (IMQ), which measures Communication, Gross Motor, Fine Motor, Adaptive and Personal–Social development. Cut‐off scores are available for each scale at each age to identify children with ‘clinically significant’ developmental delays. Chi‐square analyses and generalized estimating equations examined longitudinal associations between sex‐specific quartiles of BioT concentrations and the rate of developmental delay.

Results:  Significantly more males than females had language delay (Communication scale) at age 1, 2 and 3 years (p‐values ≤. 01). Males were also more likely to be classified as delayed on the Fine‐Motor (p = .04) and Personal–Social (p < .01) scales at age 3 years. Chi‐square analyses found a significant difference between BioT quartiles in the rate of language delay (but not Fine‐Motor and Personal–Social delay) for males (age 3) and females (age 1 and 3). Generalized estimating equations, incorporating a range of sociodemographic and obstetric variables, found that males in the highest BioT quartile were at increased risk for a clinically significant language delay during the first 3 years of life, with an odds ratio (OR) of 2.47 (95% CI: 1.12, 5.47). By contrast, increasing levels of BioT reduced the risk of language delay among females (Quartile 2: OR = 0.23, 95% CI: 0.09, 0.59; Quartile 4: 0.46, 95% CI: 0.21, 0.99).

Conclusion:  These data suggest that high prenatal testosterone levels are a risk factor for language delay in males, but may be a protective factor for females.
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Document Type: Research Article

Affiliations: 1: Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia 2: School of Psychology, University of Western Australia, Perth, Western Australia 3: Discipline of Paediatrics, University of Adelaide, South Australia 4: School of Women’s and Infants’ Health, University of Western Australia, Perth, Western Australia 5: Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria

Publication date: July 1, 2012

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