Early Predictors of Developmental Delays in Low-Income Pediatric Populations: A Cross-Sectional Study from Urban Clinics in Nigeria

Developmental delays in early childhood can significantly impair long-term cognitive, behavioral, and social outcomes. In Nigeria, children from low-income urban communities face increased risk due to socioeconomic hardships, poor access to early health interventions, and limited routine developmental screening. This cross-sectional study investigated early predictors of developmental delays in children aged 6 months to 5 years attending public and faith-based primary healthcare clinics in low-income urban areas of Lagos, Kano, and Port Harcourt. Data were collected from 704 pediatric patients using caregiver interviews, health records, vaccination history, and adapted screening tools, including milestone checklists and the Ages and Stages Questionnaire (ASQ-3), where available. Findings revealed that 24% of children screened were at risk for developmental delays. Multivariate analysis identified key predictors: maternal education below secondary level (adjusted OR: 2.7, 95% CI: 1.8–4.0), frequent missed immunization appointments (OR: 2.1, 95% CI: 1.3–3.4), caregiver-reported developmental concerns before age two (OR: 3.0, 95% CI: 1.9–4.7), and poor nutritional status (based on weight-for-age and MUAC scores). The study underscores the urgent need for integrating simple, validated developmental screening tools into Nigeria’s routine child health visits, and for strengthening maternal education and caregiver involvement in early child development surveillance in urban, low-resource settings.