Delivery Mode, Maternal Characteristics, and Developmental Trajectories of Toddlers’ Emotional and Behavioral Problems
Little empirical research examines relationships among delivery mode, other childbirth-related factors, maternal characteristics, and child psychosocial development.
The aim of this study is to explore the developmental trajectories of toddlers’ emotional and behavioral problems and the predictive role of psycho-social, childbirth, and maternal characteristics.
Participants were 258 mothers and their children who took part in a longitudinal study from birth till the age of 30 months. Self-report instruments were used for the assessment of mothers’ infant rearing attitudes, the quality of relationship with the partner, maternal emotional distress, and maternal self-efficacy. The Child Behavior Checklist (1½–5) was used for the assessment of children’s behavioral and emotional problems.
Latent class analysis for emotional and behavioral problems ended in 3-class solutions. In regard to emotional problems, 83% of children were classified as having a stable low, 11% an increasing, and 6% a decreasing level of emotional problems. In regard to behavioral problems, 86% of children showed a stable low, 5% an increasing, and 9% a stable high level of behavioral problems. Children’s gender in combination with maternal education and maternal infant rearing attitudes predict children’s membership in the increasing and decreasing emotional problem classes. Children’s gender and maternal age in combination with emergency caesarean section, the quality of the relationship with the partner, and maternal self-efficacy explain children’s membership in the classes of high and increasing behavioral problems.
A combination of such factors as emergency caesarean section, child’s gender, maternal age and level of education, maternal infant rearing attitudes, maternal self-efficacy, and inter-parental relationships predict developmental trajectories of emotional and behavioral problems in toddlers.
KeywordsEmotional and behavioral problems Developmental trajectories Delivery mode Emergency caesarean section Maternal self-efficacy Infant rearing attitudes
This research is a part of the prospective birth-cohort study initiated in 2009. We thank a whole group of scientists from Vilnius University and Lithuanian university of Health sciences who has worked on this study, as well as the mothers who participated in it.
This research is part of the project funded by the following Grants: T-09157/2009 from the Lithuanian State Science and Studies Foundation, MIP-147/2010 from the Research Council of Lithuania, and MIP-014/2012 from the Research Council of Lithuania.
Compliance with Ethical Standards
Conflict of interest
Jurgita Smilte Jasiulione declares that she has no conflict of interest. Roma Jusiene has received research Grants from Lithuanian State Science and Studies Foundation and the Research Council of Lithuania; however the funders have not intervened and/or influenced the research and the content of the manuscript.
All procedures performed were in accordance with the ethical standards of the national research committee and with 1964 Helsinki declaration and its later amendments. The study was approved by Regional Biomedical Research Ethics Committee (No. P1‐143/2007).
It was obtained from all participating mothers.
- Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA preschool forms & profiles. Burlington, VT: University of Vermont, Department of Psychiatry.Google Scholar
- Andersen, L. B., Melvaer, L. B., Videbech, P., Lamont, R. F., & Joergensen, J. S. (2012). Risk factors for developing post-traumatic stress disorder following childbirth: A systematic review. Acta Obstetricia et Gynecologica Scandinavica, 91, 1261–1272. https://doi.org/10.1111/j.1600-0412.2012.01476.x.CrossRefGoogle Scholar
- Chien, L. N., Lin, H. C., Shao, Y. H., Chiou, S. T., & Chiou, H. Y. (2015). Risk of autism associated with general anesthesia during caesarean delivery: A population-based birth-cohort analysis. Journal of Autism and Developmental Disorders, 45(4), 932–942. https://doi.org/10.1007/s10803-014-2247-y.CrossRefGoogle Scholar
- Fuchs, S., Klein, A. M., Otto, Y., & von Klitzing, K. (2013). Prevalence of emotional and behavioral symptoms and their impact on daily life activities in a community sample of 3 to 5-year-old children. Child Psychiatry and Human Development, 44, 493–503. https://doi.org/10.1007/s10578-012-0343-9.CrossRefGoogle Scholar
- Giallo, R., Cooklin, A., Wade, C., D’Esposito, F., & Nicholson, J. M. (2013). Maternal postnatal mental health and later emotional–behavioral development of children: The mediating role of parenting behavior. Child: Care, Health and Development, 40(3), 327–336. https://doi.org/10.1111/cch.12028.Google Scholar
- Hobbs, A. J., Mannion, C. A., McDonald, S. W., Brockway, M., & Tough, S. C. (2016). The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy and Childbirth, 16, 90. https://doi.org/10.1186/s12884-016-0876-1.CrossRefGoogle Scholar
- Jusienė, R., & Raižienė, S. (2006). Ikimokyklinio amžiaus vaikų elgesio bei emocinių sunkumų įvertinimas: motinų, tėčių ir auklėtojų vertinimų lyginamoji analizė. Psichologija, 33, 47–63.Google Scholar
- Jusienė, R., & Žalienė, J. (2012). Nėštumo ir gimdymo komplikacijų bei psichosocialinių veiksnių įtaka pogimdyminei depresijai. Lietuvos akušerija ir ginekologija, 15(1), 23–33.Google Scholar
- Leis, J. A., Heron, J., Stuart, E. A., & Mendelson, T. (2014). Associations between maternal mental health and child emotional and behavioral problems: Does prenatal mental health matter? Journal of Abnormal Child Psychology, 42, 161–171. https://doi.org/10.1007/s10802-013-9766-4.CrossRefGoogle Scholar
- Metsälä, J., Kilkkinen, A., Kaila, M., Tapanainen, H., Klaukka, T., Gissler, M., et al. (2008). Perinatal factors and the risk of asthma in childhood: A population-based register study in Finland. American Journal of Epidemiology, 168, 170–178. https://doi.org/10.1093/aje/kwn105.CrossRefGoogle Scholar
- Muthén, L. K., & Muthén, B. O. (2006). Mplus users guide. Los Angeles, CA: Muthén and Muthén.Google Scholar
- Rijlaarsdam, J., Stevens, G. W. J. M., van der Ende, J., Hofman, A., Jaddoe, V. W. V., Mackenbach, J. P., et al. (2013). Economic disadvantage and young children’s emotional and behavioral problems: Mechanisms of risk. Journal of Abnormal Child Psychology, 41, 125–137. https://doi.org/10.1007/s10802-012-9655-2.CrossRefGoogle Scholar
- Van IJzendoorn, M. H., Bakermans-Kranenburg, M. J., & Juffer, F. (1999). The parental efficacy questionnaire. Leiden University, Center for Child and Family Studies (Unpublished Manuscript).Google Scholar
- Weaver, C. M., Shaw, D. S., Dishion, T. J., & Wilson, M. N. (2008). Parenting self-efficacy and problem behavior in children at high risk for early conduct problems: The mediating role of maternal depression. Infant Behavior and Development, 31(4), 594–605. https://doi.org/10.1016/j.infbeh.2008.07.006.CrossRefGoogle Scholar
- WHO. (2013). Comprehensive mental health action plan 2013–2020. Retrieved January 8, 2019 from http://www.who.int/mental_health/publications/action_plan/en/.