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American Journal of Epidemiology Advance Access published online on March 8, 2006
American Journal of Epidemiology, doi:10.1093/aje/kwj108
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.
Received August 19, 2005
Accepted December 13, 2005

ORIGINAL CONTRIBUTIONS

Fetal Growth and Childhood Behavioral Problems: Results from the ALSPAC Cohort

Nicola J. Wiles 1 *, Tim J. Peters 2, Jon Heron 3, David Gunnell 4, Alan Emond 5, Glyn Lewis 1, and for the ALSPAC Study Team

1 Academic Unit of Psychiatry, Department of Community Based Medicine, University of Bristol, Bristol, United Kingdom
2 Academic Unit of Primary Care, Department of Community Based Medicine, University of Bristol, Bristol, United Kingdom
3 Avon Longitudinal Study of Parents and Children, Department of Community Based Medicine, University of Bristol, Bristol, United Kingdom
4 Department of Social Medicine, University of Bristol, Bristol, United Kingdom
5 Academic Centre for Child and Adolescent Health, Department of Community Based Medicine, University of Bristol, Bristol, United Kingdom

* To whom correspondence should be addressed.
Nicola J. Wiles, E-mail: nicola.wiles{at}bristol.ac.uk


  Abstract

Using data on 4,813 children from the ALSPAC cohort in Bristol, United Kingdom, recontacted in 1998-1999, the authors investigated whether intrauterine growth restriction (indexed by birth weight and length) was associated with behavioral problems at age 7 years. Childhood behavioral problems were measured by using a brief behavioral screening questionnaire (the Strengths and Difficulties Questionnaire (parental completion)). For term singleton infants, a one standard deviation increase in birth weight was associated with an 11% reduction in the odds of behavioral problems at age 81 months. After adjustment for confounders and birth length, this association was no longer seen. The association with birth length remained after adjustment for confounders. A one standard deviation increase in birth length was associated with a 14% decrease in the odds of being in the top tertile of total behavioral difficulties at age 81 months (odds ratio = 0.86, 95% confidence interval: 0.79, 0.95) and was similarly associated with hyperactivity and conduct problems. Evidence was weak for an association between birth length and behavioral problems earlier in childhood. In summary, there was a weak association between intrauterine growth restriction, indexed by birth length (rather than weight), and childhood behavioral problems. Future work should focus on elucidating the biologic mechanisms that lead to variations in birth length and underlie this association.

Keywords: birth weight; body height; child behavior; fetal development.
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