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Long term cognitive development in children with prolonged crying
  1. M R Rao1,*,
  2. R A Brenner1,
  3. E F Schisterman1,
  4. T Vik2,
  5. J L Mills1
  1. 1Epidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
  2. 2Department of Community Medicine and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
  1. Correspondence to:
    Dr M R Rao
    National Institute of Allergy and Infectious Diseases, 6610 Rockledge Drive–Room 5095, Bethesda, MD 20892-6603, USA;


Background: Long term studies of cognitive development and colic have not differentiated between typical colic and prolonged crying.

Objective: To evaluate whether colic and excessive crying that persists beyond 3 months is associated with adverse cognitive development.

Design: Prospective cohort study. A sample of 561 women was enrolled in the second trimester of pregnancy. Colic and prolonged crying were based on crying behaviour assessed at 6 and 13 weeks. Children’s intelligence, motor abilities, and behaviour were measured at 5 years (n = 327). Known risk factors for cognitive impairment were ascertained prenatally, after birth, at 6 and 13 weeks, at 6, 9, and 13 months, and at 5 years of age.

Results: Children with prolonged crying (but not those with colic only) had an adjusted mean IQ that was 9 points lower than the control group. Their performance and verbal IQ scores were 9.2 and 6.7 points lower than the control group, respectively. The prolonged crying group also had significantly poorer fine motor abilities compared with the control group. Colic had no effect on cognitive development.

Conclusions: Excessive, uncontrolled crying that persists beyond 3 months of age in infants without other signs of neurological damage may be a marker for cognitive deficits during childhood. Such infants need to be examined and followed up more intensively.

  • PDMS, Peabody developmental motor scales
  • PIC, personality inventory for children
  • PIQ, performance intelligence quotient
  • SGA, small for gestational age
  • VIQ, verbal intelligence quotient
  • cognitive development
  • colic
  • prolonged crying

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  • * Dr Rao’s current affiliation: Parasitology and International Programs Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland