title: Effects of pregnancy planning, fertility, and assisted reproductive treatment on child behavioral problems at 5 and 7 years: evidence from the Millennium Cohort Study.
abstract: OBJECTIVE
  To examine the effects of pregnancy planning, time to conception (TTC), and assisted reproductive technologies (ART) on child behavior.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  A total of 12,380 singletons recruited at 9 months and followed-up at 5 and 7 years. Conceptions were divided into "unplanned" (unplanned, unhappy), "mistimed" (unplanned, happy), "planned" (planned, TTC <12 months), "subfertile" (planned, TTC ≥ 12 months), "ovulation induced" (received clomiphene citrate), and "ART" (IVF or intracytoplasmic sperm injection).
  
  
  METHODS
  None.
  
  
  METHODS
  Child behavior (Strengths and Difficulties Questionnaire [SDQ]).
  
  
  RESULTS
  Mistimed and unplanned children had higher average SDQ scores at age 5 and 7 years and were significantly more likely to have a clinically relevant behavioral problem compared with the planned group. The ART children had significantly higher average SDQ scores at both 5 and 7 years compared with the planned group. An increase in clinically relevant behavioral problems was observed at 5 years (odds ratio 2.05 [95% confidence interval 0.96, 4.42]) but failed to reach statistical significance. No effects were observed in the subfertile and ovulation-induced groups.
  
  
  CONCLUSIONS
  Unplanned and mistimed children exhibit more behavioral problems than their planned peers. Though ART children have higher mean total difficulties scores, this did not translate into a statistically significant increase in clinically relevant behavioral problems.
authors.affiliation: National Perinatal Epidemiology Unit, University of Oxford, Oxford, United Kingdom. claire.carson@npeu.ox.ac.uk
authors.forename: Claire
authors.initials: C
authors.lastname: Carson
authors.forename: Maggie
authors.initials: M
authors.lastname: Redshaw
authors.forename: Amanda
authors.initials: A
authors.lastname: Sacker
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Kelly
authors.forename: Jenny J
authors.initials: JJ
authors.lastname: Kurinczuk
authors.forename: Maria A
authors.initials: MA
authors.lastname: Quigley
mesh_terms: D015984:Causality; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000523:psychology; D002675:Child, Preschool; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007246:Infertility / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000523:psychology / Q000706:statistics & numerical data*; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology