Estupiñán-Pérez VH, Jiménez-Urrego ÁM, Botero Carvajal A. Clinical and environmental risk factors for childhood developmental disabilities: A narrative review (1990-2025). World J Clin Pediatr 2026; 15(3): 119109 [DOI: 10.5409/wjcp.119109]
Corresponding Author of This Article
Alejandro Botero Carvajal, MD, PhD, Professor, Senior Researcher, School of Health, Universidad Santiago de Cali, 5th Street, No. 62-00, Pampalinda Neighborhood, Cali 760001, Colombia. alejandro.botero00@usc.edu.co
Research Domain of This Article
Pediatrics
Article-Type of This Article
review-article
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World J Clin Pediatr. Sep 9, 2026; 15(3): 119109 Published online Sep 9, 2026. doi: 10.5409/wjcp.119109
Clinical and environmental risk factors for childhood developmental disabilities: A narrative review (1990-2025)
Víctor Hugo Estupiñán-Pérez, Ángela María Jiménez-Urrego, Alejandro Botero Carvajal
Víctor Hugo Estupiñán-Pérez, Respiratory Therapy Program, Universidad Santiago de Cali, Cali 76001, Valle del Cauca, Colombia
Ángela María Jiménez-Urrego, Department of Psychology, Pontificia Universidad Javeriana, Cali 760001, Valle del Cauca, Colombia
Alejandro Botero Carvajal, School of Health, Universidad Santiago de Cali, Cali 760001, Colombia
Author contributions: Estupiñán-Pérez VH and Jiménez-Urrego ÁM conducted methodological guidance; Jiménez-Urrego ÁM and Botero Carvajal A conducted data extraction; Estupiñán-Pérez VH provided critical review; Botero Carvajal A conceptualized the study, interpreted findings, and finalized the manuscript. All authors approved the final version.
AI contribution statement: AI-assisted tools were used during manuscript preparation. The manuscript was written by the authors. All scientific content reflects the authors’ original intellectual work and critical synthesis of the literature. AI tools did not generate scientific content. AI tools were used for English language editing, stylistic refinement, clarity improvement, and limited translation of author-written text. No AI tools were used for data analysis. Study design, literature selection, critical appraisal of included studies, thematic synthesis, interpretation of findings, and conclusions were performed exclusively by the authors. No figures, tables, or images were generated using AI tools.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Alejandro Botero Carvajal, MD, PhD, Professor, Senior Researcher, School of Health, Universidad Santiago de Cali, 5th Street, No. 62-00, Pampalinda Neighborhood, Cali 760001, Colombia. alejandro.botero00@usc.edu.co
Received: January 20, 2026 Revised: February 5, 2026 Accepted: March 26, 2026 Published online: September 9, 2026 Processing time: 192 Days and 2.5 Hours
Abstract
Developmental disabilities (DD) affect millions of children worldwide and disproportionately burden low- and middle-income countries. Modifiable risks include early-life clinical procedures and environmental/psychosocial exposures, but syntheses spanning 1990-2025, including the coronavirus disease 2019, remain limited. To narratively review evidence on clinical and environmental risk factors for DD in children < 18 years. PubMed (1990-2025) was searched using SPIDER. Clinical trials, cohorts, and population-based studies were thematically synthesized across clinical procedural and environmental/psychosocial domains. Thirty-two studies were included (19 clinical/procedural; 13 environmental/psychosocial/early intervention), enrolling > 100000 participants; registry studies added > 1.8 million. Cardiac surgery for congenital heart disease was associated with below-average cognitive and motor scores, driven mainly by perioperative complexity, low birth weight, and prolonged intensive care rather than surgical technique. Maternal mental illness was linked to adverse neurodevelopmental outcomes (adjusted odds ratio: Approximately 3-4). Multidomain, family-centered interventions - including telehealth - improved developmental outcomes and reduced delay. Several cohorts reported increased developmental concerns during and after coronavirus disease 2019, particularly in communication and social-emotional domains. Clinical and environmental/psychosocial factors are major, potentially modifiable determinants of DD; priorities include strengthened developmental surveillance, caregiver mental health assessment, and equitable access to early intervention.
Core Tip: Developmental disabilities arise from the interaction of clinical factors (cardiac surgery, neonatal complications) and environmental determinants (maternal mental health, poverty, coronavirus disease 2019-related disruptions). Cardiac surgery outcomes are largely driven by perioperative complexity and intensive care morbidity rather than surgical technique alone. Maternal mental illness shows strong associations with adverse child outcomes, and multidomain, family-centered early interventions - including telehealth delivery - produce meaningful improvements across developmental domains. Pediatric systems should integrate systematic developmental surveillance, caregiver mental health care, and equitable access to early intervention, especially for children whose early years overlapped with the coronavirus disease 2019 pandemic.
