Risk factors at birth and later developmental risk of mental disorders

Ms Felicity Harris1, Professor Kimberlie Dean1,2, Mr Oliver Watkeys1, Dr Gabrielle Hindmarsh1, Associate Professor Kristin Laurens1,3, Dr Stacy Tzoumakis1,4, Professor Vaughan Carr1,5,6, Professor Melissa Green1,5

1School of Psychiatry, University of New South Wales, Sydney, Australia, 2Justice Health & Forensic Mental Network, Matraville, Australia, 3School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia, 4School of Criminology and Criminal Justice, Griffith University, Southport, Australia, 5Neuroscience Research Australia, Sydney, Australia, 6Department of Psychiatry, Monash University, Melbourne, Australia

We previously identified population risk profiles for later childhood mental disorders, comprising patterns of early developmental vulnerabilities on the Australian Early Developmental Census (AEDC). Whether these developmental risk profiles for emerging psychopathology are associated with risk factors earlier in the life course (e.g., at the time of birth) is of interest to policy makers. Here we set out to determine the associations between risk factors known at birth and the developmental risk profiles. Data for 66,464 children and their parents were drawn from the NSW Child Development Study, an intergenerational multi-agency linkage project being conducted for the 2009 NSW AEDC cohort. Multinomial logistic regression analyses were used to estimate the associations between 16 perinatal and familial risk indicators at birth and risk profile membership in the ‘pervasive risk’ (3.7%, characterised by global AEDC vulnerabilities), ‘misconduct risk’ (6.8%, characterised by externalising behaviours), and ‘mild generalised risk’ (10.8%) profiles, relative to children showing virtually ‘no risk’ (78.7%). Children classified into either ‘pervasive risk’ or ‘misconduct risk’ profiles at school entry were 2-3 times more likely to be male, and more likely to have a mother with a mental illness, or either parent with a history of criminal charges. In addition, having a prenatal child protection report showed strong associations with ‘pervasive risk’ and moderate associations with ‘misconduct risk’.  However, exposure to a range of perinatal risk factors was significantly associated with the ‘pervasive risk’ and ‘mild generalised risk’ profiles only (e.g., >2 previous pregnancies, birth complications, maternal smoking during pregnancy, preterm birth). These findings suggest that early prevention programs for emerging psychopathology could be implemented via perinatal and/or early childhood services in the first 2000 days, to mitigate the long-term consequences of early childhood developmental risk for mental disorders.


Ms Felicity Harris is a Research Officer and PhD candidate at the UNSW Sydney. Ms Harris has a Masters in Clinical Epidemiology and experience in epidemiological research relevant to mental health, child protection, criminology and education. Her PhD research using the NSW Child Development Study cohort aims to determine the earliest predictors of developmental (age 5 years) risk profiles for later childhood mental disorders, as well as the associations between these early childhood risk profiles and later academic underachievement or self-reported psychopathology in middle childhood, as known precursors to adult mental disorders.