O-250 Association of child neurodevelopmental and behavioural problems with maternal unemployment in a population-based birth cohort

Abstract

<h3>Introduction</h3> Mothers typically adjust their work participation in order to meet family needs, including their children’s well-being. However, there is scarce evidence on the impact of children’s poor mental health on maternal employment in less affluent European economies, where the dual-earner family structure is often necessary to make ends meet. <h3>Objectives</h3> To estimate associations between suspected and diagnosed neurodevelopmental and behavioural problems in 7-year-old children and maternal unemployment at child ages 7 and 10, in a Portuguese birth cohort. <h3>Methods</h3> We evaluated 5754 mother-child pairs of the population-based birth cohort Generation XXI. Data on child suspected and diagnosed neurodevelopmental and behavioural problems, namely learning, attention and language problems, externalizing behaviours, developmental delay, autism spectrum disorders, and other neurodevelopmental problems, were retrieved at 7 years of age using caregivers’ reports. Maternal employment status was collected at child age 7 and 10. Robust Poisson regression models were used to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs). <h3>Results</h3> After adjustment for maternal age, education, being a single mother, singleton/multiple pregnancy, having children under the age of 6 years, household monthly income and maternal mental disorder diagnosis, women were more likely to be unemployed at child age 10 if the child had, up to age 7, any of the following suspected problems: externalizing behaviours (PR=1.20, 95%CI [1.03–1.40]), developmental delay (PR=1.46, 95%CI [1.12–1.91]), or an autism spectrum disorder (PR=1.62, 95%CI [0.99–2.65]). When the exposure was restricted to clinically diagnosed disorders, the magnitude of associations remained similar, although estimates were less precise. Associations with unemployment were stronger when the child was 10 compared to when the child was 7. <h3>Conclusion</h3> Having a child with a developmental or behavioural problem or an autism spectrum disorder at age 7 was associated with maternal unemployment three years later, placing families at a higher risk of financial vulnerability.