Objective To investigate neuropsycho-behavioral development of high risk children at Rudong County, Nantong, Jiangsu Province, and to analyze the factors associated with it so as to provide theoretical evidence for effective interventions for them.

Methods Cluster sampling was used to recruited 731 type A high-risk children and their guardians as study subjects at high-risk children clinic of Rudong County Maternal and Child Health Family Planning Service Center in Nantong, Jiangsu from January 2019 to August 2021. Self-designed questionnaire and Gesell development scale were used for evaluation. The test results of each dimension were expressed by the development quotient score. Logistic regression was used to analyze the factors associated with neuropsychological development among high-risk children.

Results Totally 731 high-risk infants were involved in our study, including 414 boys (56.63%) and 317 girls (43.37%); The average age of them was (14.78 ± 5.20) months. The evaluation results of neuropsychological-behavioral development revealed that 238(32.56%) were normal, 385(52.67%) were borderline, and 108(14.77%) were developmental delay. The detection rates of developmental retardation in terms of adaptability, large motor activity, refinement, language, and individual social intercourse were 4.92%(36), 3.15%(23), 1.92% (14), 12.72%(93), and 8.10%(59), respectively. Logistic regression analysis showed that intrauterine distress and advanced maternal age (AMA) were risk factors for adaptive developmental delay (OR = 6.08, P < 0.001; OR = 2.88, P < 0.001); AMA and older mongth of age were risk factors for gross motor developmental delay (OR = 2.79, P = 0.03; OR = 1.14, P < 0.001); full term was a protective factor for fine motor developmental delay (OR = 0.08, P < 0.001); AMA and intergenerational parenting were risk factors for delayed language development (OR = 3.69, P < 0.001; OR = 1.94, P < 0.001).

Conclusion Primary child health care institutions need to further improve the quality of perinatal management to reduce the occurrence of complications, and strengthen the advocacy of 'three-child policy', particularly focus on the impact on neuropsychological development of high-risk children among women of AMA.