{
  "abstract": "Background: Socioeconomic inequalities in children's emotional and behavioural problems are already present at school entry. We examined associations between early‐life socioeconomic conditions and children's externalising and internalising problems and assessed whether early‐life risk factors mediated these associations.\n\nMethods: We analysed harmonised individual participant data from eight birth cohorts within the EU Child Cohort Network. Maternal educational level during pregnancy was used as an indicator of early‐life socioeconomic conditions (SECs). Scores of children's externalising and internalising problems around school entry age were used as the outcome variables. Inequalities were quantified using the Slope Index of Inequality which captures the difference in prevalence of problems between children from highest and lowest SECs. Mediation analysis was used to assess the mediating role of five early‐life risk factors: maternal smoking during pregnancy, gestational age, small for gestational age, postpartum depression and breastfeeding.\n\nResults: Inequalities in externalising and internalising problems by SECs were consistent across cohorts: Children of mothers with low educational level had on average a 12 and 11 percentage point increased prevalence of externalising and internalising problems respectively. Early‐life factors explained around 8% (DNBC, Denmark) to 54% (INMA, Spain) of the inequality in externalising problems and 7% (ELFE, France) to 25% (ALSPAC, UK) in internalising problems.\n\nConclusions: Children from lower SECs consistently had a higher prevalence of both externalising and internalising problems around school entry age. These inequalities were partly mediated by early‐life factors. Public health interventions in pregnancy and the preschool period are critical to address the early emergence of inequalities in children's mental health.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Public Health University of Copenhagen Copenhagen Denmark",
    "Department of Public Health, Policy and Systems University of Liverpool Liverpool UK",
    "Department of Genetics, Genomics Coordination Center University Medical Center Groningen, University of Groningen Groningen The Netherlands",
    "Barcelona Institute for Global Health (ISGlobal) Barcelona Spain",
    "School of Population and Global Health The University of Western Australia Perth Australia",
    "French National Institute of Health and Medical Research (INSERM), French National Institute for Demographic Studies (INED), Joint Unit Elfe Aubervilliers France",
    "MRC Integrative Epidemiology Unit University of Bristol Bristol UK",
    "Department of Paediatrics, Sant Joan Reus Hospital University Rovira i Virgili, IISPV Reus Spain",
    "Division of Metabolic and Nutritional Medicine, Department of Paediatrics Dr. von Hauner Children's Hospital, LMU University Hospital Munich Germany",
    "German Center for Child and Adolescent Health, Site Munich Munich Germany",
    "Neonatal Department and Neonatal Intensive Care Unit Children's Memorial Health Institute Warsaw Poland",
    "Nutrition & Health Innovation Research Institute Edith Cowan University Perth Australia",
    "Centre for Fertility and Health Norwegian Institute of Public Health Oslo Norway",
    "Environmental Epidemiology and Child Development Unit Biogipuzkoa Health Research Institute Donostia‐San Sebastián Spain",
    "Spanish Consortium for Research and Public Health (CIBERESP) Instituto de Salud Carlos III Madrid Spain",
    "Clinical and Epidemiological Neuroscience (NeuroÈpia) Institut d'Investigació Sanitària Pere Virgili (IISPV) Reus Spain",
    "The Australian Research Centre in Sex, Health and Society La Trobe University Melbourne Vic. Australia",
    "Research Group in Social Determinants of Health and Demographic Change‐OPIK Department of Sociology and Social Work University of the Basque Country (UPV/EHU) Leioa (Biscay) Spain",
    "Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust Bradford UK",
    "French National Institute of Health and Medical Research (INSERM) Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Epidémiologie Sociale, Santé Mentale Addictions (ESSMA) Paris France",
    "Menzies Institute for Medical Research, University of Tasmania Hobart Tas. Australia",
    "Department of Genetics and Bioinformatics, Division of Health Data and Digitalisation Norwegian Institute of Public Health Oslo Norway",
    "School of Public Health Imperial College London London UK",
    "Department of Medical Sciences University of Turin Turin Italy",
    "Department of Medicine, Faculty of Health Sciences Universitat Jaume I Castellón de la Plana Spain",
    "Epidemiology and Environmental Health Joint Research Unit FISABIO–Universitat Jaume I‐University of Valencia Valencia Spain",
    "Universitat Pompeu Fabra Barcelona Spain",
    "IMIM‐Parc Salut Mar Barcelona Catalonia Spain",
    "Pediatric Unit Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy",
    "Groupe Santé CHC Liège Belgium"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 38,
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    {
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        1
      ],
      "name": "Demetris Avraam",
      "orcid": "0000-0001-8908-2441"
    },
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        1
      ],
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        5
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      "name": "Marie Aline Charles"
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        1
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      "name": "Yu Wei Chua",
      "orcid": "0000-0002-2174-6149"
    },
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        6
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      "name": "Ahmed Elhakeem"
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        7
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      "name": "Joaquín Escribano"
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        8,
        9
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      "name": "Veit Grote"
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      "name": "Kathrin Guerlich"
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      "name": "Rae‐Chi Huang"
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      "name": "Jennifer R. Harris"
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      "name": "Jesus Ibarluzea"
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      "name": "Jordi Julvez",
      "orcid": "0000-0003-0818-4003"
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        9
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      "name": "Berthold Koletzko"
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    {
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        4,
        16
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      "name": "Ashleigh Lin"
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    {
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        17
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      "name": "Unai Martin"
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    {
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        18
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      "name": "Rosemary McEachan"
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    {
      "affs": [
        19
      ],
      "name": "Maria Melchior"
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    {
      "affs": [
        4,
        20
      ],
      "name": "Phillip Melton"
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    {
      "affs": [
        21
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      "name": "Johanna Thorbjornsrud Nader"
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    {
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        0,
        22
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      "name": "Angela Pinot de Moira"
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    {
      "affs": [
        23
      ],
      "name": "Maja Popovic"
    },
    {
      "affs": [
        24
      ],
      "name": "Simona Porru"
    },
    {
      "affs": [
        23
      ],
      "name": "Lorenzo Richiardi"
    },
    {
      "affs": [
        25
      ],
      "name": "Blanca Sarzo"
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    {
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        1
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      "name": "Daniela Schlüter"
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      "name": "Jordi Sunyer"
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      "name": "Morris Swertz"
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    {
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      "name": "Elvira Verduci"
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    {
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      "name": "John Wright"
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    {
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      "name": "Annick Xhonneux"
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    {
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      "name": "Tiffany Yang"
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    {
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      "name": "Daniela Zugna"
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      "name": "Anne‐Marie Nybo Andersen"
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    {
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        0
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      "name": "Katrine Strandberg‐Larsen",
      "orcid": "0000-0001-7061-3767"
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    {
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        1
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      "name": "David Taylor‐Robinson"
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  "bibtex": "https://research.draconitic.com/paper/8ebm38a66y15s.bib",
  "cited_by": 0,
  "doi": "10.1111/jcpp.70207",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13745791/",
  "id": "8ebm38a66y15s",
  "issns": [
    "0021-9630",
    "1469-7610"
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  "landing_url": "https://doi.org/10.1111/jcpp.70207",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
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      "3203|Child and Adolescent Psychosocial and Emotional Development"
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  "pdf_url": null,
  "pmcid": "PMC13745791",
  "pmid": "42521261",
  "published": "2026-07-28",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/8ebm38a66y15s.ris",
  "sources": [
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      "first_seen": "2026-11-11T12:23:19Z",
      "native_id": "PMC13745791",
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      "url": "https://doi.org/10.1111/jcpp.70207"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:3203|Child and Adolescent Psychosocial and Emotional Development",
      "subfield": "psychiatry"
    }
  ],
  "title": "Early‐life pathways to inequalities in child mental health: evidence from eight birth cohorts",
  "title_text": "Early‐life pathways to inequalities in child mental health: evidence from eight birth cohorts",
  "type": "peer-reviewed",
  "updated_at": "2026-11-12T12:22:13Z",
  "url": "https://research.draconitic.com/paper/8ebm38a66y15s",
  "venue": "Journal of Child Psychology and Psychiatry, and Allied Disciplines",
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}