Perinatal risk and protective factors associated with diagnosis of mental health disorders in children by age 9 years

BACKGROUND: Early identification of children who are at risk of developing mental health disorders is essential for implementing prevention and intervention approaches. The perinatal period is a unique time to identify these risks, as well as protective factors, due to the high frequency of contact with healthcare professionals. METHODS: The current study linked longitudinal cohort data from the All Our Families study (Canada) with administrative health records up to age 9 years (n = 2,814), to identify risk and protective factors from the perinatal period (pregnancy through to first year of life) that are associated with common mental health diagnoses, specifically ADHD and emotional disorders. Parents also reported via surveys whether their child had received a mental health diagnosis prior to age 9 years. RESULTS: For a diagnosis of ADHD via administrative health records or parent report by age 9 years, risk factors included maternal post-partum mental health difficulties, difficulty meeting basic financial needs, an unwanted pregnancy, infant feeding and sleeping problems, and the presence of the child experiencing a physical health condition prior to 12 months, whereas high parent self-efficacy was associated with a decreased odds of a child ADHD diagnosis. For diagnosis of an emotional disorder, maternal postpartum mental health difficulties, single parenthood, an unwanted pregnancy, difficulty soothing the infant, and a maternal history of child maltreatment were risk factors, whereas parent optimism and partner relationship satisfaction were associated with a decreased odds of diagnosis. CONCLUSIONS: Both shared and disparate perinatal factors are associated with the diagnosis of ADHD versus an emotional disorder The perinatal period may represent a critical window for identifying both risk and protective factors, enabling healthcare professionals to deliver tailored prevention or intervention strategies that could reduce the likelihood of future mental health problems in children.