Childhood Psychiatric Symptoms May be Linked to Exposure During Pregnancy

Childhood Psychiatric Symptoms May be Linked to Exposure During Pregnancy

Jim Windell

             Does early life exposure to adverse circumstances actually increase the risk of mental illness?

            I think we know the answer to that is yes. For some time, we have been aware of the importance of the prenatal environment for brain health and for reducing risk of psychiatric symptoms in childhood. Much of this was known – or at least suggested – by a series of small studies.

            However, researchers from Massachusetts General Hospital have conducted a larger study that reinforces what was previously suspected about a child’s risk for psychiatric or behavioral problems early in life.

           In the study published recently in the open-access journal PLOS ONE, researchers looked at 9,290 children from the ages of 9 to 10 living in 21 communities in the United States. Relying on the mother's recall of events during pregnancy, the study evaluated the effects of adverse prenatal exposures, such as an unplanned pregnancy, maternal use of alcohol, tobacco or marijuana before pregnancy was recognized, complications during pregnancy (such as high blood pressure or gestational diabetes), and complications during labor and delivery.

           The study found that children subjected during pregnancy to two or more of six adverse exposures were significantly more likely to have clinically significant scores on the Child Behavior Checklist (CBCL), indicating a higher level of problems such as depression, attention difficulties or anxiety.

           "While individually these factors had previously been associated with similar risks in prior, often smaller studies, this is the first time that we were able to gauge the effect of cumulative exposures, which were fairly dramatic," says lead author Joshua L. Roffman, M.D., MMSc, director of the Massachusetts General Early Brain Development Initiative.

           For example, while children with none of the exposures during their mother's pregnancy had only a 7% chance of developing clinically significant psychiatric symptoms, this risk increased steeply and in a linear fashion, such that those with four or more of the exposures had a 29% chance of clinically significant symptoms. The researchers saw similar patterns across a range of specific symptoms, from mood and anxiety to attention and thought disturbances.

           The associations between prenatal exposures and psychiatric symptoms in childhood held up even when the researchers accounted for other factors that might skew the results, such as the mother's socioeconomic status, or exposures after birth that are known to increase a child's risk for psychiatric disorders, such as a traumatic life event.

           To validate their findings, Roffman and colleagues also tested them in a separate group of non-twin siblings who differed in their exposures during pregnancy. Here, too, the data showed that the sibling with the higher number of exposures was at greater risk for more severe symptoms.

           "Our findings reinforce the importance of the prenatal environment for brain health and for reducing risk of psychiatric symptoms in childhood,” says Roffman, who is also an associate professor of Psychiatry at Harvard Medical School. “This brings increased urgency to the need to discover, develop and implement early life interventions that mitigate some of these risks."

           To read the original journal article, find it with this reference:

Roffman, J.L., Sipahi, E.D., Dowling, K.F., Hughes, D.E., Hopkinson, C.E., Lee, H., Eryilmaz, H., Cohen, L.S., Gilman, J., Doyle, A.E., & Dunn, E.C. (2021). Association of adverse prenatal exposure burden with child psychopathology in the Adolescent Brain Cognitive Development (ABCD) StudyPLOS ONE, 16 (4): e0250235 DOI: 10.1371/journal.pone.0250235

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