Eunice Kennedy Shriver Center, UMass Chan Medical School, Worchester, Massachusetts.
Johns Hopkins University, Baltimore, Maryland.
J Am Acad Child Adolesc Psychiatry. 2023 Dec;62(12):1351-1362. doi: 10.1016/j.jaac.2023.05.010. Epub 2023 May 17.
This cohort study assessed perinatal factors known to be related to maternal and neonatal inflammation and hypothesized that several would be associated with emotional, cognitive, and behavioral dysregulation in youth.
The Environmental influences on Child Health Outcomes (ECHO) is a research consortium of 69 pediatric longitudinal cohorts. 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 was used. Children were classified as having the CBCL-Dysregulation Profile (CBCL-DP) if the sum of their T scores for 3 CBCL subscales (attention, anxious/depressed, and aggression) was ≥180. Primary exposures were perinatal factors associated with maternal and/or neonatal inflammation, and associations between these and outcome were assessed.
Approximately 13.4% of 4,595 youth met criteria for CBCL-DP. Boys were affected more than girls (15.1% vs 11.5%). More youth with CBCL-DP (35%) were born to mothers with prenatal infections compared with 28% of youth without 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.
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 CBCL-DP and could be targets for interventions to improve behavioral outcomes of offspring.
DIVERSITY & INCLUSION STATEMENT: We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
本队列研究评估了已知与母婴炎症相关的围产期因素，并假设其中一些因素与青少年的情绪、认知和行为失调有关。
环境对儿童健康结果的影响（ECHO）是一个由 69 个儿科纵向队列组成的研究联盟。使用了一个包含 18 个队列的子集，这些队列既有儿童（6-18 岁）的儿童行为检查表（CBCL）数据，也有围产期暴露信息，包括母亲产前感染。如果儿童的 3 个 CBCL 分量表（注意力、焦虑/抑郁和攻击）的 T 分数总和≥180，则将其归类为具有 CBCL 失调特征（CBCL-DP）。主要暴露因素是与母婴和/或新生儿炎症相关的围产期因素，并评估了这些因素与结局之间的关联。
大约 13.4%的 4595 名青少年符合 CBCL-DP 的标准。男孩比女孩受影响更大（15.1%对 11.5%）。与没有 CBCL-DP 的青少年相比，有 CBCL-DP 的青少年（35%）中，母亲有产前感染的比例更高（35%对 28%）。调整后的优势比表明，以下因素与失调显著相关：一级亲属有精神疾病；母亲受教育程度较低、肥胖、有任何产前感染以及/或在怀孕期间吸烟。
在这项大型研究中，一些具有既定炎症作用的可改变的母体危险因素（母亲受教育程度较低、肥胖、产前感染和吸烟）与 CBCL-DP 强烈相关，可能是改善后代行为结果的干预措施的目标。
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