Life-course fertility patterns associated with childhood externalizing and internalizing behaviors.

Childhood behavioral problems have been associated with earlier childbearing, but their life-course reproductive consequences are unknown. The present study examined whether and how behavioral problems assessed in childhood predict fertility patterns over the life course in women and men. Participants were 9,472 individuals from the British National Child Development Study (4,739 men and 4,733 women). Childhood externalizing and internalizing behaviors were rated by teachers at ages 7 and 11. Information on fertility history was derived from interviews at ages 33, 42, and 46, including date of pregnancy, whether the pregnancy was planned or non-planned, and pregnancy outcome (live birth, miscarriages/stillbirth, induced abortion). Transition to parenthood and fertility rate were assessed using survival analysis and age-stratified regression models. In both sexes, higher externalizing behavior was associated with higher rate of pregnancies, especially non-planned pregnancies in adolescence and early adulthood, but this association attenuated or even reversed later in adulthood. Internalizing behavior was associated with lower pregnancy rates, especially planned pregnancies and later in adulthood, and particularly in men. In women, higher internalizing behavior was also associated with earlier transition to parenthood. Externalizing behavior in women predicted higher risk of miscarriages and induced abortions, while internalizing behavior predicted lower risk for these outcomes. These findings suggest that childhood behavioral problems have long-term associations with fertility behavior over the life course, including earlier transition to parenthood, lower probability of normative family formation later in adulthood, and higher risk of adverse pregnancy outcomes.