Background: The scientific literature on the impact of early childcare on children's behavioural and emotional difficulties shows contrasting results. We studied this association in France, where childcare is of high quality and children enter preschool at the age of 3.
Methods: 1428 children from the EDEN (Etude des Déterminants du développement et de la santé de l'ENfant) mother-child cohort set up in France (Nancy and Poitiers) were followed up since pregnancy to the age of 8 years. Group-based trajectory modelling was used to model their trajectories of behavioural and emotional symptoms (emotional symptoms, peer relationship problems, hyperactivity/inattention, conduct problems, prosocial behaviours) ascertained by three measures (3, 5.5 and 8 years) of the Strengths and Difficulties Questionnaire. Using propensity scores and inverse probability weights (IPWs) to account for selection and confounding factors, we compared children in a childminder's care or in centre-based childcare (from birth to age 3) with those in informal childcare.
Results: Compared with children in informal childcare, those who attended centre-based childcare had a lower likelihood of having high levels of emotional symptoms (ORIPW-adjusted=0.35, 95% CI 0.17 to 0.71), peer relationship problems (ORIPW-adjusted=0.31, 95% CI 0.15 to 0.67) and low prosocial behaviours (ORIPW-adjusted=0.50, 95% CI 0.28 to 0.90). Those who were looked after by a childminder had a higher likelihood of following a high trajectory of conduct problems (ORIPW-adjusted=1.72, 95% CI 1.05 to 2.81). Attendance of centre-based childcare for more than 1 year was especially protective of high levels of emotional, peer-related difficulties and low prosocial behaviours. Girls and children from a favourable socioeconomic background reaped more benefits of childcare than boys and those from a less favourable background.
Conclusion: High-quality centre-based childcare may be linked to lower levels of emotional symptoms.
Keywords: child health; cohort studies; epidemiology; public health.
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