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. 2023 Dec;62(12):1351-1362.
doi: 10.1016/j.jaac.2023.05.010. Epub 2023 May 17.

Perinatal Factors and Emotional, Cognitive, and Behavioral Dysregulation in Childhood and Adolescence

Jean A Frazier  1 , Xiuhong Li  2 , Xiangrong Kong  2 , Stephen R Hooper  3 , Robert M Joseph  4 , David M Cochran  5 , Sohye Kim  5 , Rebecca C Fry  3 , Patricia A Brennan  6 , Michael E Msall  7 , Raina N Fichorova  8 , Irva Hertz-Picciotto  9 , Julie L Daniels  3 , Jin-Shei Lai  10 , Richard E Boles  11 , Bharathi J Zvara  3 , Isha Jalnapurkar  5 , Julie B Schweitzer  9 , Rachana Singh  12 , Jonathan Posner  13 , Deborah H Bennett  9 , Karl C K Kuban  14 , T Michael O'Shea  3 ; program collaborators for Environmental influences on Child Health Outcomes
Affiliations

Perinatal Factors and Emotional, Cognitive, and Behavioral Dysregulation in Childhood and Adolescence

Jean A Frazier et al. J Am Acad Child Adolesc Psychiatry. 2023 Dec.

Abstract

Objective: 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.

Method: 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.

Results: 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.

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 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.

Keywords: CBCL; adolescents; children; dysregulation; inflammation.

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Conflict of interest statement

Disclosure: Dr. Frazier has received research support from Quadrant, Healx, and Tetra Pharmaceuticals. Dr. Posner has received research support from Takeda (formerly Shire) and Aevi Genomics and consultancy fees from Innovative Science. Drs. Li, Kong, Hooper, Joseph, Cochran, Kim, Fry, Brennan, Msall, Fichorova, Hertz-Picciotto, Daniels, Lai, Boles, Zvara, Jalnapurkar, Schweitzer, Singh, Bennett, Kuban, and O’Shea have reported no biomedical financial interests or potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Flow Chart
See this image and copyright information in PMC

References

    1. Holtmann M, Buchmann AF, Esser G, Schmidt MH, Banaschewski T, Laucht M. The Child Behavior Checklist-Dysregulation Profile predicts substance use, suicidality, and functional impairment: A longitudinal analysis. Journal of Child Psychology and Psychiatry. 2011;52(2):139–147. doi: 10.1111/j.1469-7610.2010.02309.x - DOI - PubMed
    1. Hyde R, O’Callaghan MJ, Bor W, Williams GM, Najman JM. Long-term outcomes of infant behavioral dysregulation. Pediatrics. 2012;130(5):e1243–e1251. DOI: 10.1542/peds.2010-3517 - DOI - PubMed
    1. Kim J, Carlson GA, Meyer SE, et al. Correlates of the CBCL-dysregulation profile in preschool-aged children. Journal of Child Psychology and Psychiatry. 2012;53(9):918–926. doi: 10.1111/j.1469-7610.2012.02546.x - DOI - PMC - PubMed
    1. McQuillan ME, Kultur EC, Bates JE, et al. Dysregulation in children: Origins and implications from age 5 to age 28. Development and psychopathology. 2018;30(2):695–713. doi: 10.1017/S0954579417001572 - DOI - PMC - PubMed
    1. Achenbach TM, Ruffle TM. The Child Behavior Checklist and related forms for assessing behavioral/emotional problems and competencies. Pediatrics in review. 2000;21(8):265–271. DOI: 10.1542/pir.21-8-265 - DOI - PubMed

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