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We examined whether total number of complications experienced in the pregnancy associated with mental health at 5 and 9-years, and whether this varied by sex or adverse social circumstances. Pregnancy complications were self-reported at 9-months post-natally from a list of 16 complications. Parents completed the Strengths and Difficulties Questionnaire (SDQ) when their child was 5 and 9-years. The primary outcome was the SDQ-total and scoring in the clinical range (&gt;\u200916) was a secondary outcome. We applied generalized linear mixed models to a large nationally representative Irish cohort (GUI; n\u2009=\u200911,134). Analyses were adjusted for sex, adverse social circumstances (at 9-months), and gestational smoking. We included an interaction term between pregnancy complications and each variable respectively in separate models to examine if associations varied by sex or adverse circumstances.<\/jats:p>\n                  <jats:p>After controlling for covariates, total complications associated with mental health at 5 and 9-years. Each additional pregnancy complication conferred a 10% higher total-SDQ score (exponentiated co-efficient 1.10 [95%CI 1.06\u20131.14], 1.20 [1.15\u20131.26], 1.20 [1.12\u20131.29] and 1.34 [1.21\u20131.48] for 1, 2, 3 and 4\u2009+\u2009complications respectively). For the dichotomised outcome, generally increasing odds for clinical levels of mental health difficulties were observed (OR 1complication\u2009=\u20091.89, 95%CI [1.37\u20132.59]; OR 2complications\u2009=\u20092.31, 95%CI [1.53\u20133.50]; OR 3complications\u2009=\u20091.77, 95%CI [0.89\u20133.52]; OR 4\u2009+\u2009complications\u2009=\u20096.88, 95%CI [3.29\u201314.40]). Females had significantly lower odds of exhibiting clinically significant mental health difficulties than males (OR\u2009=\u20090.43, 95%CI[0.32\u20130.57]).<\/jats:p>\n                  <jats:p>There was no evidence that the association between pregnancy complications and child\u2019s mental health varied by sex or social circumstances at 5 or 9-years. Males exposed to numerous pregnancy complications in the context of adverse social circumstances had the highest predicted probability of having mental health difficulties in middle childhood.<\/jats:p>","DOI":"10.1007\/s00127-024-02678-2","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T15:01:40Z","timestamp":1714402900000},"page":"1697-1707","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Pregnancy complications and childhood mental health: is the association modified by sex or adverse social circumstances? Findings from the \u2018growing up in Ireland\u2019 national infant cohort study"],"prefix":"10.1007","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9769-0591","authenticated-orcid":false,"given":"Emma","family":"Butler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5155-9400","authenticated-orcid":false,"given":"Mary","family":"Clarke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2246-8910","authenticated-orcid":false,"given":"Michelle","family":"Spirtos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda M O\u2019","family":"Keeffe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3161-3996","authenticated-orcid":false,"given":"Niamh","family":"Dooley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"issue":"6","key":"2678_CR1","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/j.ajog.2019.06.013","volume":"221","author":"BJS Al-Haddad","year":"2019","unstructured":"Al-Haddad BJS et al (2019) The fetal origins of mental illness. 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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Royal College of Surgeons Ireland.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}