University of Oulu

Toffol, E., Rantalainen, V., Lahti-Pulkkinen, M. et al. Eur Child Adolesc Psychiatry (2019) 28: 847.

Infant regulatory behavior problems during first month of life and neurobehavioral outcomes in early childhood

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Author: Toffol, Elena1,2; Rantalainen, Ville1; Lahti‑Pulkkinen, Marius1,2,3;
Organizations: 1Department of Psychology and Logopedics, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014 Helsinki, Finland
2National Institute for Health and Welfare, Helsinki, Finland
3University/British Heart Foundation Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
4Helsinki Collegium for Advance Studies, University of Helsinki, Helsinki, Finland
5Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
6Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
7Institute for Molecular Medicine Finland/Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
8Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
9Department of Obstetrics and Gynaecology, Tampere University Hospital, Tampere, Finland
10HUSLAB and Department of Clinical Chemistry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
11Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
12PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.1 MB)
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Language: English
Published: Springer Nature, 2019
Publish Date: 2019-10-11


Whether infant regulatory behavior problems already in the first month of life indicate an increased risk of childhood neurobehavioral problems, and whether maternal depression in the postpartum and early childhood underpins these associations remain unclear. Altogether, 2049–2364 mothers from the Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction (PREDO) study completed the Neonatal Perception Inventory on regulatory behavior problems at the infant’s age of 15.6 days (SD 3.2, range 1–30), the Infant Behavior Questionnaire-Revised on temperament at 6.5 months (SD 0.9, range 4.2–12.4), and the Ages and Stages Questionnaire-3 on developmental milestones and the Child Behavior Checklist on behavioral problems at 3.5 years (SD 0.7, range 1.9–6.0). Maternal depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale (infancy follow-ups) and Beck Depression Inventory-II (childhood follow-up). Father-rated infant temperament and paternal depressive symptoms were also available (n = 1474). Higher levels of infant regulatory behavior problems predicted higher levels of mother- and father-rated negative affectivity temperament (0.13 SD units per SD unit, 95% confidence interval 0.09–0.17; and 0.09, 0.04–0.14, respectively), lower levels of mother-rated orienting/regulation temperament (− 0.09, − 0.13 to − 0.05) and problem-solving skills (− 0.12, − 0.21 to − 0.04), and higher levels of Externalizing (0.07, 0.03–0.11) and Total behavioral problems (0.07, 0.03–0.11). Regulatory behaviors partially mediated the effect of maternal depressive symptoms. Regulatory behavior problems already during the first month of life predict neurobehavioral outcomes, and partially mediate the effect of maternal depressive symptoms. Our study may inform design of interventions aimed at timely prevention in children at risk.

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Series: European child & adolescent psychiatry
ISSN: 1018-8827
ISSN-E: 1435-165X
ISSN-L: 1018-8827
Volume: 28
Issue: 6
Pages: 847 - 859
DOI: 10.1007/s00787-018-1243-8
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
3123 Gynaecology and paediatrics
Funding: Open access funding provided by University of Helsinki including Helsinki University Central Hospital. The PREDO study is funded by the Academy of Finland, European Commission (Horizon 2020 Framework Programme Award SC1-2016-RTD-733280 RECAP), EVO, University of Helsinki Research Funds; Helsingin Yliopiston Tiedesäätiö, the Signe and Ane Gyllenberg, Emil Aaltonen, Jane and Aatos Erkko, Novo Nordisk, Päivikki and Sakari Sohlberg, Sigrid Juselius Foundations; the Finnish Medical Foundation.
Copyright information: © The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.