Frazier JA, Li X, Kong X, Hooper SR, Joseph RM, Cochran DM, Kim S, Fry RC, Brennan PA, Msall ME, Fichorova RN, Hertz-Picciotto I, Daniels JL, Lai JS, Boles RE, Zvara BJ, Jalnapurkar I, Schweitzer JB, Singh R, Posner J, Bennett DH, Kuban KCK, O’Shea TM; program collaborators for Environmental influences on Child Health Outcomes.
J Am Acad Child Adolesc Psychiatry. 2023 May 15:S0890-8567(23)00248-4. doi: 10.1016/j.jaac.2023.05.010. Epub ahead of print. PMID: 37207889.
Objective: In this cohort study, we assessed perinatal factors known to be related to maternal and neonatal inflammation and hypothesized several would be associated with emotional, cognitive, and behavioral dysregulation in youth.
Method: The Environmental Influences on Child Health Outcomes is a research consortium of 69 pediatric longitudinal cohorts. We used a subset of 18 cohorts that had both Child Behavior Checklist (CBCL) data on children (6-18 years) and information on perinatal exposures including maternal prenatal infections. Children were classified as having the CBCL dysregulation profile (CBCL-DP) if the sum of their T-Scores for three CBCL subscales (attention, anxious/depressed, and aggression) was ≥ 180. Perinatal factors associated with maternal and/or neonatal inflammation were our primary exposures and we assessed associations between these and our outcome.
Results: Approximately 13.4 % of 4,595 youth met criteria for the CBCL-DP. Boys were affected more than girls (15.1% vs 11.5%). More youth with the CBCL-DP (35%) were born to mothers with prenatal infection(s), compared to 28% of youth without the CBCL-DP. Adjusted odds ratios indicated the following were significantly associated with dysregulation: having a first degree relative with a psychiatric disorder, being born to a mother with lower educational attainment, who was obese, had any prenatal infection and/or who smoked tobacco during pregnancy.
Conclusion: In this large study, a few modifiable maternal risk factors with established roles in inflammation (maternal lower education, obesity, prenatal infections, and smoking) were strongly associated with the CBCL-DP and could be targets for interventions to improve offspring’s behavioral outcomes.