Birth Complications, Temperamental Self-Regulation, and Emotion Regulation and Their Associations with Internalizing and Externalizing Behaviour Problems in Childhood

Background: Birth complications may be associated with behavioural adjustment, but the regulatory processes linking specific perinatal conditions to internalizing and externalizing problems remain unclear. This cross-sectional study analysed the relations between middle childhood behaviour problems, temperamental self-regulation, emotion regulation, and birth complications. Methods: Questionnaires on birth complications, inhibitory control, impulsivity, emotion regulation, and internalizing and externalizing behaviour problems were filled out by caregivers of 534 children between the ages of 5 and 11. Preterm birth, mild complications, caesarean delivery, and severe complications were the categories used to categorize birth complications, with no complications serving as the reference group. Indirect correlations were assessed, and path analyses were calculated. Results: Caesarean delivery, preterm birth, and severe complications were associated with lower inhibitory control, but not with higher impulsivity or poorer emotion regulation. Higher impulsivity and lower emotion regulation were associated with more internalizing problems, whereas lower inhibitory control, higher impulsivity, and lower emotion regulation were associated with more externalizing problems. Significant specific indirect associations with externalizing problems through inhibitory control were identified for caesarean delivery and preterm birth, with an additional association through impulsivity for caesarean delivery. The total indirect association with externalizing problems was significant only for caesarean delivery. No significant indirect associations through emotion regulation were found. Conclusions: Findings suggest differentiated associations between birth complications, regulatory characteristics, and childhood behavioural problems.