Elsevier

The Journal of Pediatrics

Volume 162, Issue 2, February 2013, Pages 335-342
The Journal of Pediatrics

Original Article
Infant Behaviors Are Predictive of Functional Somatic Symptoms at Ages 5-7 Years: Results from the Copenhagen Child Cohort CCC2000

https://doi.org/10.1016/j.jpeds.2012.08.001Get rights and content

Objective

To investigate infancy predictors of impairing functional somatic symptoms (FSS) at child ages 5-7 years with a focus on problems with feeding, sleep, and tactile reactivity.

Study design

This study is part of a longitudinal birth cohort study, Copenhagen Child Cohort CCC2000. Child health, development, and functioning were assessed by community health nurses at 4 home visits from birth to age 10 months. FSS at ages 5-7 years were measured by the Soma Assessment Interview in 1327 children. Sociodemographic data and information on maternal psychiatric illness were obtained from the Danish National Registers.

Results

Multiple logistic regression analysis controlled for maternal psychiatric illness and annual household income revealed that combined infancy regulatory problems (ie, at least 2 of 3 problems of feeding, sleeping, or tactile reactivity during the first 10 months of living) predicted impairing FSS at 5-7 years (aOR = 2.9, 95% CI: 1.3-6.6). Maternal psychiatric illness during the child's first year of living was also associated with later child FSS (aOR = 7.1, 95% CI: 1.8-27.8).

Conclusion

Regulatory problems may be an early marker of disturbed sensory reactivity in young children, which together with maternal psychiatric problems, point to possible early risk mechanisms of impairing FSS in childhood.

Section snippets

Methods

This study was part of the Copenhagen Child Cohort CCC2000,17 counting all 6090 children born in a well-defined geographical area around Copenhagen, Denmark, in 2000. The cohort has been followed prospectively since birth.

At the 5-7 years follow-up, a random sample of 3000 members of the cohort was assessed, of whom 2912 were eligible for inclusion in the present study. Nine had died and 79 were not contactable. Complete data on FSS were available for a total of 1327 children from the random

Results

The overall prevalence of any FSS was 23.2% (n = 308) with a higher prevalence among girls than boys (27.6 vs 18.8%, X2 = 14.41, P < .0001). Impairing FSS were found in 4.4% (n = 58), and in this subgroup, there was no statistically significant sex difference. Pain complaints (ie, limb pain, headache, and/or stomach ache) were the most frequent types of FSS. Further details on the epidemiology of FSS in this sample have been described elsewhere.3

Data from infancy (at least 1 routine health

Discussion

Children experiencing combined problems in the regulation of feeding, sleep, and/or tactile reactivity during infancy have a nearly 3-fold increased risk of impairing FSS at ages 5-7 years, whereas no significant associations were found regarding FSS without impairment. Thus, the differentiation between clinically-significant symptoms and the very common, nonimpairing symptoms that affect every child at one time or another seem to be important and suggest the relevance of including impairment

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    Funded by TrygFonden, the Pharmaceutical Fund, the Beatrice Surovel Haskell Fund for Child Mental Health Research of Copenhagen, Mrs C. Hermansen's Memorial Fund, Lily Bethine Lund's Fund, the Research Initiative of Aarhus University Hospital Clinical Institute (Aarhus University), the Research Fund of 2004, the Medical Association in Aarhus, the Pool for Psychiatric Research (Aarhus County), Dagmar Marshall's Fund, King Christian X Fund, the Fund of Research in Mental Disorders, Rosalie Petersen's Fund, the Research Fund of the Danish Medical Association, the Fund of Research in Public Health (Aarhus County) and the Augustinus Fund. The authors declare no conflicts of interest.

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