ArticleBMJ open2026
Maternal out-of-home care experience and offspring symptom development across domains: a latent profile analysis of a UK longitudinal population sample.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis prospective longitudinal study of a general population sample investigates whether maternal experience of out-of-home care (OHC) constitutes an independent risk factor for the development of externalising and internalising symptoms in offspring, after adjusting for other commonly associated aetiologic risks.
participants18 810 families in the UK Millennium Cohort Study with complete information provided by the birth mother regarding her OHC experience and ethnicity. PRIMARY OUTCOME MEASURES: Offspring externalising and internalising symptoms assessed by the Strengths and Difficulties Questionnaire as reported by the birth mother.
designLatent profile analysis of offspring behavioural adjustment trajectories to identify distinct patterns of co-occurring internalising and externalising problem trajectories from age 3 to 17 years. The role of maternal OHC experience and other risk factors as predictors of adjustment patterns were examined descriptively and using multinomial regression.
resultsFive groups of symptom trajectories were identified: two normative groups with very low (33%) and low symptom levels (40%) and three problem behaviour groups including high externalising/moderate internalising (10%), high internalising/high externalising (5%) and moderate internalising/high externalising (12%). Compared with the normative group, higher symptoms were predicted by family socioeconomic status (SES), housing conditions, maternal health, parent-child relationship and child characteristics. Maternal OHC experience was a significant risk factor for all three problem groups, with the highest relative risk (RRR 4.82) observed for children showing high internalising/externalising symptoms. However, after controlling for the other risk factors, maternal OHC experience was no longer significantly associated with higher symptoms.
conclusionMaternal OHC experience is associated with an elevated risk of offspring presenting adjustment problems, characterised by co-occurring internalising and externalising symptom trajectories. However, the impact of maternal OHC experience on their children's adjustment was fully attenuated by other common etiological risks, suggesting that these factors play a critical role in mediating the risk.
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