Background and aims One in six children experience developmental problems at school entry. Early intervention is more effective than later remediation; however, to date, we lack a comprehensive understanding of risk and protective factors. The objectives of this study were to describe the key risk factors for poor child development at age 12 months and to identify factors that reduce the potentially adverse influence of poor maternal mental health and low socioeconomic status on child development.

Methods We used data from the All Our Babies (AOB) study, a prospective pregnancy cohort in Calgary, Alberta. Five domains of child development at age 12 months were assessed via parent report using the Ages and Stages Questionnaire (ASQ) from approximately 1500 mothers. The associations between putative risk factors and poor child development were examined in bivariate and multivariable analyses. A bivariate resilience analysis was also conducted to identify factors related to positive child development in the presence of maternal mental health or sociodemographic risk.

Results Key risk factors for poor child development at age 12 months included poor maternal mental health during pregnancy, and low community resource use and lack of adult interaction in the first postpartum year. In addition to parenting efficacy, uptake of community resources and increased adult interaction were protective of poor child development among children most at risk for this outcome.

Conclusions As many of the identified risk and protective factors are modifiable, these results can inform community based strategies to optimise early childhood development.