Birth order and socioeconomic disadvantage predict behavioural and emotional problems at age 3 years

Acta Paediatr. 2021 Dec;110(12):3294-3301. doi: 10.1111/apa.16094. Epub 2021 Sep 8.

Abstract

Aim: The aim of this study was to describe sociodemographic and family predictors for behavioural and emotional problems in pre-schoolers.

Methods: This was a cross-sectional study including 30,795 children in the Stockholm region whose parents had completed the Strength and Difficulties Questionnaire (SDQ) prior to a routine visit to a well-baby clinic at age 3 years. Multivariate logistic regression was used to analyse predictors for having a high total SDQ difficulties score.

Results: Young parental age and a low level of parental education predicted high total SDQ score in a stepwise pattern. Being a first-born child was associated with a high SDQ score with an adjusted odds ratio of 2.10 (95% C.I. 1.84-2.41), compared with having older siblings. A sole physical custody arrangement predicted a high total SDQ score after parental separation. The percentage of children with a high total SDQ score increased with the Care Need Index (CNI) of the well-baby clinic.

Conclusions: This study identified socioeconomic disadvantage and being the first-born child as the main predictors of poor mental health at age 3 years. Well-baby clinics with socioeconomically disadvantaged catchment areas should be provided with adequate resources and methods for equitable prevention.

Keywords: inequity; mental health; pre-school children; prevention; single parent; young parents.

MeSH terms

  • Birth Order*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Divorce
  • Humans
  • Mental Health
  • Parents*
  • Surveys and Questionnaires