EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600, Porto, Portugal.
Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, nº 135, 4050-600, Porto, Portugal.
Soc Psychiatry Psychiatr Epidemiol. 2024 Apr;59(4):643-655. doi: 10.1007/s00127-023-02464-6. Epub 2023 Mar 26.
To estimate associations between suspected or diagnosed neurodevelopmental or behavioural problems in 7-year-old children and maternal unemployment at child age 7 and 10, in a Portuguese birth cohort.
We evaluated 5754 mothers and their children of the population-based birth cohort Generation XXI in Porto, Portugal. Data on suspected and diagnosed child neurodevelopmental and behavioural problems (exposures)-learning, attention and language problems, externalising behaviours, developmental delay, autism spectrum disorders, and other neurodevelopmental problems-were retrieved at 7 years of age by interviewing caregivers. Maternal employment status (outcome) was collected at the 7- and 10-year follow-up waves. Robust Poisson regression models were used to estimate associations.
After adjustment for maternal and household characteristics, 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: an autism spectrum disorder (PR = 1.73; 95% CI 1.07, 2.79), developmental delay (PR = 1.58; 95% CI 1.20, 2.06), externalising behaviours (PR = 1.29; 95% CI 1.11, 1.50) or learning problems (PR = 1.26; 95% CI 1.07, 1.48). When the exposure was restricted to clinically diagnosed disorders, the magnitude of associations remained similar but estimates were less precise. Associations with unemployment were stronger at child age 10 (prospective analyses), than at child age 7 (cross-sectional).
Having a child with learning, developmental or behavioural problems, or an autism spectrum disorder up to age 7 was associated with maternal unemployment three years later, even in a less affluent European economy where the dual-earner family structure is often necessary to make ends meet.
在葡萄牙的一个出生队列中，估计 7 岁儿童疑似或确诊的神经发育或行为问题与儿童 7 岁和 10 岁时母亲失业之间的关联。
我们评估了葡萄牙波尔图的基于人群的 21 世纪一代出生队列中的 5754 名母亲及其子女。通过对照顾者进行访谈，在 7 岁时收集了疑似和确诊儿童神经发育和行为问题（暴露）的数据，包括学习、注意力和语言问题、外化行为、发育迟缓、自闭症谱系障碍和其他神经发育问题。在 7 岁和 10 岁的随访中收集了母亲的就业状况（结局）。使用稳健泊松回归模型来估计关联。
在调整了母亲和家庭特征后，如果孩子在 7 岁之前有以下任何一种疑似问题，那么孩子在 10 岁时母亲更有可能失业：自闭症谱系障碍（PR=1.73；95%CI 1.07，2.79）、发育迟缓（PR=1.58；95%CI 1.20，2.06）、外化行为（PR=1.29；95%CI 1.11，1.50）或学习问题（PR=1.26；95%CI 1.07，1.48）。当将暴露限制为临床诊断的疾病时，关联的幅度仍然相似，但估计值不太精确。与失业的关联在孩子 10 岁时更强（前瞻性分析），而在孩子 7 岁时较弱（横断面分析）。
在 7 岁之前，孩子患有学习、发育或行为问题或自闭症谱系障碍与 3 年后母亲失业有关，即使在一个较不富裕的欧洲经济体中，双职工家庭结构通常也是维持生计所必需的。
