Abstract
Background
Early childcare attendance may be related to children's internalizing and externalizing symptoms throughout childhood and young adolescence, however evidence from Europe is limited. We aimed to assess this association across multiple population-based birth cohorts of children recruited in different European countries.
Methods
Data come from six parent-offspring prospective birth cohort studies across five European countries within the EU Child Cohort Network. A total of 87,208 parent-child dyads were included in the study. To test associations between childcare attendance (centre-based or informal) anytime between ages 0 and 4 years and children's internalizing and externalizing symptoms in middle childhood and young adolescence (measured at: 5–6 years, 7–9 years, and 10–13 years) a two-stage individual participant data meta-analysis was implemented. Linear regression models were performed in each cohort separately; combined random-effects meta-analysis was then used to obtain overall association estimates. In secondary analyses, we tested interactions between childcare attendance and mother's post-partum depression, low education status, and the child's sex.
Findings
Compared to children who were exclusively cared for by their parents prior to school entry, those who attended centre-based childcare had lower levels of internalizing symptoms in all age groups [5–6 years: β: −1.78 (95% CI: −3.39, −0.16); 7–9 years: β: −0.55 (95% CI: −0.88, −0.73); 10–13 years: β: −0.76 (95% CI: −1.15, −0.37)]. Children who attended informal childcare appeared to have elevated levels of internalizing symptoms between 7–9 and 10–13 years, respectively [β: 1.65 (95% CI: 1.25, 2.06); β: 1.25 (95% CI: 0.96, 1.54)]. Informal childcare attendance was also associated with increased levels of children's externalizing symptoms between 7–9 and 10–13 years, respectively [β: 2.84 (95% CI: 1.41, 4.26); β: 2.19 (95% CI: 0.54, 3.84)].
Interpretation
Early centre-based childcare is associated with decreased levels of children's internalizing symptoms compared to exclusive parental care. For informal childcare, opposite associations were observed. Overall, our results suggest that centre-based childcare attendance may be associated with slight positive impacts on children's emotional development and should be encouraged by public policies. In addition, children from socioeconomically disadvantaged families require special attention, as they may not sufficiently benefit from universal early childhood education and care (ECEC).
Early childcare attendance may be related to children's internalizing and externalizing symptoms throughout childhood and young adolescence, however evidence from Europe is limited. We aimed to assess this association across multiple population-based birth cohorts of children recruited in different European countries.
Methods
Data come from six parent-offspring prospective birth cohort studies across five European countries within the EU Child Cohort Network. A total of 87,208 parent-child dyads were included in the study. To test associations between childcare attendance (centre-based or informal) anytime between ages 0 and 4 years and children's internalizing and externalizing symptoms in middle childhood and young adolescence (measured at: 5–6 years, 7–9 years, and 10–13 years) a two-stage individual participant data meta-analysis was implemented. Linear regression models were performed in each cohort separately; combined random-effects meta-analysis was then used to obtain overall association estimates. In secondary analyses, we tested interactions between childcare attendance and mother's post-partum depression, low education status, and the child's sex.
Findings
Compared to children who were exclusively cared for by their parents prior to school entry, those who attended centre-based childcare had lower levels of internalizing symptoms in all age groups [5–6 years: β: −1.78 (95% CI: −3.39, −0.16); 7–9 years: β: −0.55 (95% CI: −0.88, −0.73); 10–13 years: β: −0.76 (95% CI: −1.15, −0.37)]. Children who attended informal childcare appeared to have elevated levels of internalizing symptoms between 7–9 and 10–13 years, respectively [β: 1.65 (95% CI: 1.25, 2.06); β: 1.25 (95% CI: 0.96, 1.54)]. Informal childcare attendance was also associated with increased levels of children's externalizing symptoms between 7–9 and 10–13 years, respectively [β: 2.84 (95% CI: 1.41, 4.26); β: 2.19 (95% CI: 0.54, 3.84)].
Interpretation
Early centre-based childcare is associated with decreased levels of children's internalizing symptoms compared to exclusive parental care. For informal childcare, opposite associations were observed. Overall, our results suggest that centre-based childcare attendance may be associated with slight positive impacts on children's emotional development and should be encouraged by public policies. In addition, children from socioeconomically disadvantaged families require special attention, as they may not sufficiently benefit from universal early childhood education and care (ECEC).
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | 101036 |
| Tidsskrift | The Lancet Regional Health - Europe |
| Vol/bind | 45 |
| Antal sider | 12 |
| ISSN | 2666-7762 |
| DOI | |
| Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:The \u00C9tude des D\u00E9terminants pr\u00E9 Et postnatals du D\u00E9veloppement de la sant\u00E9 de l'enfant (EDEN) study was supported by Foundation for medical research (FRM), National Agency for Research (ANR), National Institute for Research in Public health (IRESP: TGIR cohorte sant\u00E9 2008 program), French Ministry of Health (DGS), French Ministry of Research, INSERM Bone and Joint Diseases National Research (PRO-A) and Human Nutrition National Research Programs, Paris-Sud University, Nestl\u00E9, French National Institute for Population Health Surveillance (InVS), French National Institute for Health Education (INPES), the European Union FP7 programmes (FP7/2007-2013, HELIX, ESCAPE, ENRIECO, Medall projects), Diabetes National Research Program (through a collaboration with the French Association of Diabetic Patients (AFD)), French Agency for Environmental Health Safety (now ANSES), Mutuelle G\u00E9n\u00E9rale de l\u2019Education Nationale a complementary health insurance (MGEN), French national agency for food security, French speaking association for the study of diabetes and metabolism (ALFEDIAM).
Funding Information:
The general design of the Generation R Study is made possible by financial support from the Erasmus MC, University Medical Centre, Rotterdam, Erasmus University Rotterdam, Netherlands Organization for Health Research and Development (ZonMw), Netherlands Organisation for Scientific Research (NWO), Ministry of Health, Welfare and Sport and Ministry of Youth and Families. This project received funding from the European Union's Horizon 2020 research and innovation programme (LIFECYCLE, grant agreement No 733206, 2016; EUCAN-Connect grant agreement No 824989; ATHLETE, grant agreement No 874583).
Funding Information:
The Danish National Birth Cohort (DNBC) was established with a significant grant from the Danish National Research Foundation. Additional support was obtained from the Danish Regional Committees, the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defects Foundation, the Health Foundation and other minor grants. The DNBC Biobank has been supported by the Novo Nordisk Foundation and the Lundbeck Foundation. Follow-up of mothers and children have been supported by the Danish Medical Research Council (SSVF 0646, 271-08-0839/06-066023, O602-01042B, 0602-02738B), the Lundbeck Foundation (195/04, R100-A9193), The Innovation Fund Denmark 0603-00294B (09-067124), the Nordea Foundation (02-2013-2014), Aarhus Ideas (AU R9-A959-13-S804), University of Copenhagen Strategic Grant (IFSV 2012), and the Danish Council for Independent Research (DFF \u2013 4183-00594 and DFF - 4183-00152).
Funding Information:
The \u00C9tude Longitudinale Fran\u00E7aise depuis l'Enfance (ELFE) cohort received funding from the National Research Agency Investment for the Future program [ANR-11-EQPX-0038]; French National Institute for Research in Public Health (IRESP TGIR 2009-2001 program); Ministry of Higher Education and Research; Ministry of Environment; Ministry of Health; French Agency for Public Health; Ministry of Culture; and National Family Allowance Fund.
Funding Information:
This research was funded by the ERC Consolidator grant RESEDA (Horizon Europe, 101001420).Funding: The EU Child Cohort Network has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 733206. Additionally, participating cohort studies received multiple sources of funding. ALSPAC: The Avon Longitudinal Study of Parents and Children (ALSPAC) receives core funding from the University of Bristol, UK Medical Research Council and Wellcome (217065/Z/19/Z). A comprehensive list of grants funding is available on the ALSPAC website (http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf). Generation R: The general design of the Generation R Study is made possible by financial support from the Erasmus MC, University Medical Centre, Rotterdam, Erasmus University Rotterdam, Netherlands Organization for Health Research and Development (ZonMw), Netherlands Organisation for Scientific Research (NWO), Ministry of Health, Welfare and Sport and Ministry of Youth and Families. This project received funding from the European Union's Horizon 2020 research and innovation programme (LIFECYCLE, grant agreement No 733206, 2016; EUCAN-Connect grant agreement No 824989; ATHLETE, grant agreement No 874583). DNBC: The Danish National Birth Cohort (DNBC) was established with a significant grant from the Danish National Research Foundation. Additional support was obtained from the Danish Regional Committees, the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defects Foundation, the Health Foundation and other minor grants. The DNBC Biobank has been supported by the Novo Nordisk Foundation and the Lundbeck Foundation. Follow-up of mothers and children have been supported by the Danish Medical Research Council (SSVF 0646, 271-08-0839/06-066023, O602-01042B, 0602-02738B), the Lundbeck Foundation (195/04, R100-A9193), The Innovation Fund Denmark 0603-00294B (09-067124), the Nordea Foundation (02-2013-2014), Aarhus Ideas (AU R9-A959-13-S804), University of Copenhagen Strategic Grant (IFSV 2012), and the Danish Council for Independent Research (DFF\u20144183-00594 and DFF\u20134183-00152). INMA: The INfancia y Medio Ambiente Project (INMA) was funded by grants from the Instituto de Salud Carlos III (Red INMA G03/176) and the Generalitat de Catalunya-CIRIT (1999SGR 00241). INMA-Valencia was funded by Grants from UE (FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1), Spain: ISCIII (G03/176; FIS-FEDER: PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI14/00891, PI14/01687, and PI16/1288; Miguel Servet-FEDER CP11/00178, CP15/00025, and CPII16/00051), and Generalitat Valenciana: FISABIO (UGP 15-230, UGP-15-244, and UGP-15-249). INMA-Gipuzkoa was funded by grants from the Instituto de Salud Carlos III (FISFIS PI06/0867, FISPS09/0009) 0867, Red INMA G03/176) and the Departamento de Salud del Gobierno Vasco (2005111093 and 2009111069) and the Provincial Government of Guip\u00FAzcoa (DFG06/004 and FG08/001). INM-Menorca was funded by grants from the Instituto de Salud Carlos III (Red INMA G03/176). This study was supported by funding from the European Community's Seventh Framework Programme (FP7/2007-206) under grant agreement no 308333\u2014the HELIX project. EDEN: The \u00C9tude des D\u00E9terminants pr\u00E9 Et postnatals du D\u00E9veloppement de la sant\u00E9 de l'enfant (EDEN) study was supported by Foundation for medical research (FRM), National Agency for Research (ANR), National Institute for Research in Public health (IRESP: TGIR cohorte sant\u00E9 2008 program), French Ministry of Health (DGS), French Ministry of Research, INSERM Bone and Joint Diseases National Research (PRO-A) and Human Nutrition National Research Programs, Paris-Sud University, Nestl\u00E9, French National Institute for Population Health Surveillance (InVS), French National Institute for Health Education (INPES), the European Union FP7 programmes (FP7/2007-2013, HELIX, ESCAPE, ENRIECO, Medall projects), Diabetes National Research Program (through a collaboration with the French Association of Diabetic Patients (AFD)), French Agency for Environmental Health Safety (now ANSES), Mutuelle G\u00E9n\u00E9rale de l'Education Nationale a complementary health insurance (MGEN), French national agency for food security, French speaking association for the study of diabetes and metabolism (ALFEDIAM). The study received approval from the ethics committee (CCPPRB) of Kremlin Bic\u00EAtre on 12 December 2002 and from CNIL (Commission Nationale Informatique et Libert\u00E9), the French data privacy institution. Women gave written informed consent for themselves and their child. Fathers gave written informed consent for themselves. ELFE: The \u00C9tude Longitudinale Fran\u00E7aise depuis l'Enfance (ELFE) cohort received funding from the National Research Agency Investment for the Future program [ANR-11-EQPX-0038]; French National Institute for Research in Public Health (IRESP TGIR 2009-2001 program); Ministry of Higher Education and Research; Ministry of Environment; Ministry of Health; French Agency for Public Health; Ministry of Culture; and National Family Allowance Fund.
Funding Information:
the INfancia y Medio Ambiente Project (INMA) was funded by grants from the Instituto de Salud Carlos III (Red INMA G03/176) and the Generalitat de Catalunya-CIRIT (1999SGR 00241). INMA-Valencia was funded by Grants from UE (FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1), Spain: ISCIII (G03/176; FIS-FEDER: PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI14/00891, PI14/01687, and PI16/1288; Miguel Servet-FEDER CP11/00178, CP15/00025, and CPII16/00051), and Generalitat Valenciana: FISABIO (UGP 15-230, UGP-15-244,and UGP-15-249). INMA-Gipuzkoa was funded by grants from the Instituto de Salud Carlos III (FISFIS PI06/0867, FISPS09/0009) 0867,Red INMA G03/176) and the Departamento de Salud del Gobierno Vasco (2005111093 and 2009111069) and the Provincial Government of Guip\u00FAzcoa (DFG06/004 and FG08/001). INM-Menorca was funded by grants from the Instituto de Salud Carlos III (Red INMA G03/176). This study was supported by funding from the European Community\u2019s Seventh Framework Programme (FP7/2007-206) under grant agreement no 308333\u2014the HELIX project.
Funding Information:
The Avon Longitudinal Study of Parents and Children (ALSPAC) receives core funding from the University of Bristol, UK Medical Research Council and Wellcome (217065/Z/19/Z). A comprehensive list of grants funding is available on the ALSPAC website ( http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf ).
Publisher Copyright:
© 2024 The Author(s)