ArticleJournal of the American Academy of Child and Adolescent Psychiatry2023
The Association Between Prenatal Infection and Adolescent Behavior: Investigating Multiple Prenatal, Perinatal, and Childhood Second Hits.
Article in Journal of the American Academy of Child and Adolescent Psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Association between maternal infections during pregnancy and offspring suicide risk: A national cohort study.Molecular psychiatry · 2026Article
- Maternal infection - but not inflammation - is associated with attention-deficit/hyperactivity disorder symptoms during childhood: a population-based cohort study.Brain, behavior, and immunity · 2026Article
- Maternal Immune Activation and Child Brain Development: A Longitudinal Population-Based Multimodal Neuroimaging Study.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2025Article
- Inflammatory markers in pregnancy - identifying drivers in four large cohorts.Frontiers in immunology · 2025Article
- Mapping prenatal predictors and neurobehavioral outcomes of an epigenetic marker of neonatal inflammation - A longitudinal population-based study.Brain, behavior, and immunity · 2024Article
- Prenatal exposure to common infections and newborn DNA methylation: A prospective, population-based study.Brain, behavior, and immunity · 2024Article
- Exposure to prenatal infection and the development of internalizing and externalizing problems in children: a longitudinal population-based study.Journal of child psychology and psychiatry, and allied disciplines · 2024Article
- Examining longitudinal associations between prenatal exposure to infections and child brain morphology.Brain, behavior, and immunity · 2024Article
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Authors and funding
11 authors at 2 institutions in 2 countries.
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Abstract
objectiveExposure to infections during pregnancy may be a potential risk factor for later psychopathology, but large-scale epidemiological studies investigating associations between prenatal infection and long-term offspring behavioral problems in the general population are scarce. In our study, we aimed to investigate the following: (1) the association between prenatal infection and adolescent behavior, (2) putative underlying pathways (mediation), and (3) "second hits" interacting with prenatal infection to increase the risk of adolescent behavior problems (moderation).
methodOur study was embedded in a prospective Dutch pregnancy cohort (Generation R; n = 2,213 mother-child dyads). We constructed a comprehensive prenatal infection score comprising common infections for each trimester of pregnancy. At age 13 to 16 years, we assessed total, internalizing, and externalizing problems, and autistic traits using the Child Behavioral Checklist and the Social Responsiveness Scale, respectively. We investigated maternal lifestyle and nutrition, perinatal factors (placental health and delivery outcomes), and child health (lifestyle, traumatic events, infections) as mediators and moderators.
resultsWe observed associations of prenatal infection with adolescent total behavioral, internalizing, and externalizing problems. The association between prenatal infection and internalizing problems was moderated by higher levels of maternal psychopathology, alcohol and tobacco use, and a higher number of traumatic childhood events. We found no association between prenatal infection and autistic traits. Yet, children exposed to prenatal infections and maternal substance use, and/or traumatic childhood events, had a higher risk of autistic traits in adolescence.
conclusionPrenatal infection may be a risk factor for later psychiatric problems as well as a disease primer making individuals susceptible to other hits later in life. STUDY PREREGISTRATION INFORMATION: Prenatal maternal infection and adverse neurodevelopment: a structural equation modelling approach to downstream environmental hits; https://osf.io/cp85a; cp85a. DIVERSITY & INCLUSION STATEMENT: We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants.
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