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Early childcare type predicts children’s emotional and behavioural trajectories into middle childhood. Data from the EDEN mother–child cohort study
  1. Ramchandar Gomajee1,
  2. Fabienne El-Khoury1,
  3. Sylvana Côté2,3,
  4. Judith van der Waerden1,
  5. Laura Pryor1,
  6. Maria Melchior1
  7. on behalf of The EDEN mother-child Cohort Study Group
  1. 1 INSERM U1136, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Social Epidemiology Research Team (ERES), Paris, France
  2. 2 INSERM U1219, Université de Bordeaux, Bordeaux, France
  3. 3 Département de Médecine Sociale et Préventive, Université de Montréal, Montreal, Canada
  1. Correspondence to Ramchandar Gomajee, INSERM U1136, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Social Epidemiology Research Team (ERES), Paris, France; ramchandar.gomajee{at}, ram_gomajee{at}


Background The scientific literature on the impact of early childcare on children’s behavioural and emotional difficulties shows contrasting results. We studied this association in France, where childcare is of high quality and children enter preschool at the age of 3.

Methods 1428 children from the EDEN (Etude des Déterminants du développement et de la santé de l’ENfant) mother–child cohort set up in France (Nancy and Poitiers) were followed up since pregnancy to the age of 8 years. Group-based trajectory modelling was used to model their trajectories of behavioural and emotional symptoms (emotional symptoms, peer relationship problems, hyperactivity/inattention, conduct problems, prosocial behaviours) ascertained by three measures (3, 5.5 and 8 years) of the Strengths and Difficulties Questionnaire. Using propensity scores and inverse probability weights (IPWs) to account for selection and confounding factors, we compared children in a childminder’s care or in centre-based childcare (from birth to age 3) with those in informal childcare.

Results Compared with children in informal childcare, those who attended centre-based childcare had a lower likelihood of having high levels of emotional symptoms (ORIPW-adjusted=0.35, 95% CI 0.17 to 0.71), peer relationship problems (ORIPW-adjusted=0.31, 95% CI 0.15 to 0.67) and low prosocial behaviours (ORIPW-adjusted=0.50, 95% CI 0.28 to 0.90). Those who were looked after by a childminder had a higher likelihood of following a high trajectory of conduct problems (ORIPW-adjusted=1.72, 95% CI 1.05 to 2.81). Attendance of centre-based childcare for more than 1 year was especially protective of high levels of emotional, peer-related difficulties and low prosocial behaviours. Girls and children from a favourable socioeconomic background reaped more benefits of childcare than boys and those from a less favourable background.

Conclusion High-quality centre-based childcare may be linked to lower levels of emotional symptoms.

  • child health
  • cohort studies
  • epidemiology
  • public health

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  • Contributors MM and JEBvdW were responsible for data acquisition. MM, JEBvdW, FE-K, LP, SC and RG contributed to the design of the study. RG carried out the analyses and drafted the work. All authors contributed to critically interpreting the results and revising the draft before the approval of the final version of the manuscript. MM coordinated the progress of the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The EDEN mother–child cohort received approval from the ethics committee (CCPPRB) of Kremlin Bicêtre on 12 December 2002 and from CNIL (Commission Nationale de l’Informatique et des Libertés), the French data privacy institution.

  • Provenance and peer review Not commissioned; externally peer reviewed.