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Birthweight and behavioural problems in children: a modifiable effect?
Y J Kelly1, J Y Nazroo, A McMunn
1International Centre for Health and Society, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WCIE 6BT, UK. y,kelly@public-health.ucl.ac.uk
Insights
Low birthweight is linked to childhood behavioral issues. Social environment significantly influences this risk, potentially offering protection or increasing vulnerability regardless of birthweight.
Area of Science:
- Child Psychology
- Developmental Pediatrics
- Social Epidemiology
Background:
- Low birthweight is a known predictor of behavioral problems in children.
- The interplay between birthweight, social environment, and child behavior requires further investigation in general populations.
Purpose of the Study:
- To examine the relationship between birthweight and social factors in predicting childhood psychological well-being.
- To understand how social environment modifies the impact of birthweight on behavioral outcomes.
Main Methods:
- Cross-sectional analysis of 5181 children (aged 4-15) from the 1997 Health Survey for England.
- Utilized the Strengths and Difficulties Questionnaire (SDQ) to assess behavioral problems.
- Investigated associations with birthweight and social environmental factors.
Main Results:
- Birthweight significantly predicted total difficulties score (OR=1.27), hyperactivity in boys (OR=1.25), and peer problems in girls (OR=1.24).
- A strong social class gradient in behavioral problems was observed across all birthweight groups.
- Lower birthweight tertiles showed higher difficulties in manual social classes, with a significant trend (p<0.05).
Conclusions:
- Early life factors like birthweight and social class significantly impact child psychological well-being.
- Social factors appear to influence the effect of birthweight on behavioral problems.
- Advantaged social environments may protect against behavioral issues, while disadvantaged environments increase risk, irrespective of birthweight.
Background:
Low birthweight has been shown to predict behavioural problems in children. Less is known about the effect of birthweight, and how this may interact with the social environment in determining behaviour in a general population sample. We have examined the relationship between birthweight and social factors on childhood psychological well-being.
Methods:
Cross-sectional analysis of data on 5181 children aged 4-15 years from a randomly selected household population, the 1997 Health Survey for England. The main outcome measures were behavioural problems as defined by the Strengths and Difficulties Questionnaire (SDQ) in relation to birthweight and social environmental factors.
Results:
Birthweight was a significant predictor of total difficulties score (odds ratio [OR] = 1.27, 95% CI : 1.07, 1.49), hyperactivity in boys (OR = 1.25, 95% CI : 1.05, 1.51), and peer problems in girls (OR = 1.24, 95% CI : 0.99, 1.53). There was a strong social class gradient in the prevalence of behavioural problems for all birthweight tertiles. Bivariate analysis showed that high total difficulties score was significantly more common in lower birthweight tertiles for social classes III non-manual and III manual (P:-value for trend 0.05 and 0.03, respectively). There were smaller, non-significant effects of birthweight on the prevalence of behavioural problems in social class I and II, and IV and V. Statistical tests for an interaction between birthweight and social class were not significant.
Conclusions:
Early life factors, such as birthweight and social class have important influences on psychological well-being in children. The birthweight effect is influenced by social factors, with the possibility that an advantaged social environment protects against the development of behavioural problems, and a disadvantaged environment increases the risk of behavioural problems, regardless of birthweight.