Collaborative ECHO research led by Jean Frazier, MD, of the University of Massachusetts Chan Medical School and Mike O’Shea, MD, of the University of North Carolina at Chapel Hill investigated how factors linked with inflammation during pregnancy might be associated with dysregulation in children after birth. “Dysregulation” in this context refers to children’s attention, anxiety and depression, and aggression being measurably different from what is typically expected for children of their age.
Inflammation is a normal part of the body’s defense to injury or infection. The researchers found that several risk factors associated with inflammation, such as lower maternal educational attainment, pre-pregnancy obesity, prenatal infections, and prenatal tobacco use, were strongly correlated with dysregulation in offspring.
ECHO researchers collected data on maternal factors before and during pregnancy and then used the Child Behavior Checklist (CBCL) to identify children ages 6 to 18 with emotional, cognitive, and behavioral dysregulation. The assessments were collected between 2009 and 2021. The study involved 4,595 children and adolescents from 18 ECHO research sites across the United States.
About 13% of the children and adolescents studied were identified as having emotional and behavioral challenges. Children born to mothers with a prenatal infection had a higher risk for dysregulation later in childhood compared to children born to mothers without an infection. Lower maternal education levels, overweight before pregnancy, and smoking during pregnancy also were associated with a higher likelihood of childhood dysregulation. Children and adolescents who had a parent or sibling with a mental health disorder were more likely to experience dysregulation. Yet having a mother with gestational diabetes had no significant association with child dysregulation.
“Understanding how these factors can affect a child’s behavior can help guide interventions and support strategies to improve children’s well-being,” said Dr. Frazier.
The study highlights the importance of considering maternal inflammation risk factors when looking at children’s behavioral challenges. Future studies could explore the mechanisms linking maternal factors and childhood dysregulation, interventions for children guided by knowledge about inflammation experienced by their mother, and specific methods to prevent or mitigate the factors leading to maternal inflammation.
The research “Perinatal Factors and Emotional, Cognitive, and Behavioral Dysregulation in Childhood and Adolescence” was recently published in the Journal of the American Academy of Child and Adolescent Psychiatry.