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

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.

Automated summary

This study found that young parental age and low parental education level predicted high SDQ scores in 3-year-old children. Additionally, being a first-born child and having a sole physical custody arrangement were also predictors of high SDQ scores.