The Wirral Child Health and Development Study

Behaviour problems in young children are common and account for half the referrals to community Child and Family Mental Health services in the UK. Most worryingly, there is clear evidence that without intervention behaviour problems evident in the preschool and primary school years are strongly predictive of serious antisocial behaviours, poor mental health and interpersonal problems in adulthood. Research on the possible causes of behaviour problems and their consequences has not focussed on the very earliest origins starting in the ante-natal period. The Wirral Child Health and Development study aims to improve on previous longitudinal research by trying to identify (i) antenatal and postnatal stressors that increase risk for the development of later child behaviour problems and (ii) processes in infants and their families that promote resilience in the face of stress. We will follow the progress of 1500 families expecting their first baby with brief measures until their baby reaches one year old. A sub-sample of about 300 mothers and babies will also be asked to complete detailed interview and mother-infant measures up to their first birthdays. We subsequently plan to follow them through childhood and into adult life. Starting in pregnancy, we aim to identify the most important early social, psychological and biological risk and protective factors so that we can inform and develop appropriate early therapeutic interventions/treatments to help families in future.

We aim to identify the independent contribution of adult interpersonal functioning in the antenatal and early neonatal periods to parenting and infant development at one year, accounting for associated personality and mental health difficulties. The focus of outcome measures is on aspects of parenting and development associated later in childhood with the conduct disorders. This will be a prospective study from the antenatal period up to one year, utilising a two stage epidemiological strategy recruited from a screening (extensive) sample of 1500 women. We will establish an intensive sample (N = 300) for detailed study on the basis of screening for markers of high antenatal stress (N = 200) or low stress (N = 100). Assessments of adult functioning including personality, mental health, life stress and interpersonal functioning will be assessed from the antenatal period onwards. Multiple indices of parenting interactions, and of infant emotionality, activity, cognition and executive function associated with conduct disorders will be assessed at six and twelve months postpartum. The extensive sample will be followed to gain peri-natal and eight month health information, and brief measures of maternal and infant variables at six weeks and eight months. This multiphase strategy will enable analyses from the intensive sample to be weighted back to the general population extensive sample, enhancing statistical power and generalisability. Univariable and multivariate tests of associations between antenatal factors and one year assessments of parenting interactions and child functioning will be carried out, and possible mediators at six months and one year examined