Prenatal maternal infections and children’s socioemotional development: findings from the UK Millennium Cohort Study

Hall, Hildigunnur Anna; Speyer, Lydia Gabriela; Murray, Aja Louise; Auyeung, Bonnie

doi:10.1007/s00787-020-01644-y

Cited by 14 publications

(19 citation statements)

References 43 publications

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“…These results support those of previous studies of acetaminophen use in pregnancy and child neurodevelopmental and behavioral outcomes, which reported the confounding effect of prenatal alcohol consumption [ 3 – 6 ]. Furthermore, previous studies have found an association between maternal infection and child development including an increased risk for autism spectrum disorders [ 42 , 43 ], social and communication problems [ 44 ], and emotional symptoms [ 45 ]. However findings have been inconsistent and some studies have not found an association, which may be due to differences in the covariates included in the models, the severity of infection [ 46 ], and differences in trimester of infection [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Maternal use of acetaminophen during pregnancy and neurobehavioral problems in offspring at 3 years: A prospective cohort study

2022

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Background Acetaminophen is one of the most commonly used drugs during pregnancy globally. Recent studies have reported associations between prenatal exposure to acetaminophen and neurobehavioral problems in children, including attention-deficit hyperactivity disorders. Little research has investigated these associations in preschool-age children or the potential confounding effects of prenatal stress. The purpose of this study was to examine associations between prenatal acetaminophen exposure and offspring neurobehavioral problems at the age of 3 years, with a focus on the potentially confounding effects of prenatal stress. Methods We used data from the First Baby Study, a prospective cohort study conducted in Pennsylvania, USA, with 2,423 mother-child pairs. Women reported medication use and completed a prenatal stress inventory during their third trimester. Child behavioral problems were measured at the age of 3 years, using the 7 syndrome scale scores from the Child Behavior Checklist (CBCL) for ages 1 ½ to 5. Results There were 1,011 women (41.7%) who reported using acetaminophen during pregnancy. Children who were exposed to acetaminophen during pregnancy scored significantly higher on 3 of the 7 CBCL syndrome scales: withdrawn, sleep problems and attention problems. Scores on all 7 of the CBCL syndrome scales were significantly associated with prenatal stress. After adjustment for prenatal stress and other confounders, 2 syndrome scales remained significantly higher in children exposed to acetaminophen: sleep problems (aOR = 1.23, 95% CI = 1.01–1.51) and attention problems (aOR = 1.21, 95% CI = 1.01–1.45). Conclusions These findings corroborate previous studies reporting associations between prenatal exposure to acetaminophen and attention problems in offspring and also show an association with sleep problems at age 3 years. Because use of acetaminophen during pregnancy is common, these results are of public health concern and suggest caution in the use of medications containing acetaminophen during pregnancy.

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Section: Discussionmentioning

confidence: 99%

Maternal use of acetaminophen during pregnancy and neurobehavioral problems in offspring at 3 years: A prospective cohort study

2022

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“…Similarly, a cohort study using data from Boston and Providence, USA, found prenatal bacterial infections to be associated with reduced cognitive performance at age 7 (Lee et al ., 2020). However, other research, conducted by Hall et al . (2021) using data from a UK cohort study, found no association between hospital-recorded prenatal infections and childhood socioemotional developmental outcomes at age 3, but did find self-reported maternal infections to be associated with increased emotional problems.…”

Section: Introductionmentioning

confidence: 87%

Prenatal maternal infections and early childhood developmental outcomes: Analysis of linked administrative health data for Greater Glasgow & Clyde, Scotland

Hardie,

Murray,

King

et al. 2023

Preprint

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BackgroundPrevious research has linked prenatal maternal infections to later childhood developmental outcomes and socioemotional difficulties. However, existing studies have relied on retrospectively self-reported survey data, or data on hospital-recorded infections only, resulting in gaps in data collection.MethodsThis study used a large linked administrative health dataset, bringing together data from birth records, hospital records, prescriptions and routine child health reviews for 55,856 children born in Greater Glasgow & Clyde, Scotland, in 2011-2015, and their mothers. Logistic regression models examined associations between prenatal infections, measured as both hospital-diagnosed prenatal infections and receipt of infection-related prescription(s) during pregnancy, and childhood developmental concern(s) identified by health visitors during 6-8 weeks or 27-30 months health reviews. Secondary analyses examined whether results varied by (a) specific developmental outcome types (gross-motor-skills, hearing-communication, vision-social-awareness, personal-social, emotional-behavioural-attention, and speech-language-communication), and (b) the trimester(s) in which infections occurred.ResultsAfter confounder/covariate adjustment, hospital-diagnosed infections were associated with increased odds of having at least one developmental concern (OR: 1.30; 95% CI: 1.19-1.42). This was consistent across almost all developmental outcome types, and appeared to be specifically linked to infections occurring in pregnancy trimesters 2 (OR: 1.34; 95% CI: 1.07-1.67) and 3 (OR: 1.33; 95% CI: 1.21-1.47), i.e. the trimesters in which fetal brain myelination occurs. Infection-related prescriptions were not associated with a significant increase in odds of having at least one developmental concern after confounders/covariate adjustment (OR: 1.03; 95% CI: 0.98-1.08), but were associated with slightly increased odds of concerns specifically related to personal-social (OR: 1.12; 95% CI: 1.03-1.22) and emotional-behavioural-attention (OR: 1.15; 95% CI: 1.08-1.22) development.ConclusionsPrenatal infections, particularly those which are hospital-diagnosed (and likely more severe) are associated with early childhood developmental outcomes. Prevention of prenatal infections, and monitoring of support needs of affected children, may improve childhood development, but causality remains to be established.Key PointsPrevious studies suggest that prenatal infections, and the maternal immune activation that comes with them, are associated with child developmental outcomes. However, research to date has been based on infections data that is either self-reported or included infections diagnosed in hospital only.This study examined associations between prenatal infections, measured by both hospital-diagnosed infections and receipt of infection-related prescriptions, and child developmental concerns identified by health visitors at ages 6-8 weeks and 27-30 months.Hospital-diagnosed prenatal infections were consistently associated with developmental concerns. Maternal receipt of infection-related prescriptions during pregnancy were also associated with developmental concerns, but only those related to personal-social and emotional-behavioural-attention development.This suggests that prenatal infections, particularly severe infections, are associated with early childhood developmental outcomes.

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“…Maternal prenatal bacterial infections have been linked with lower mean IQ scores at age 7 [ 4 ], and viral infections have shown associations with decreased IQ scores at age 7 with strong effect sizes [ 5 ] and learning disabilities [ 6 ]. In addition to reported effects on children’s cognition [ 7 ] and socioemotional difficulties [ 8 ], maternal infections have also been linked to a variety of psychiatric conditions such as bipolar disorder and schizophrenia [ 9 , 10 ]. These studies demonstrate associations between maternal infections and general difficulties in cognition, behavior, and psychopathology.…”

Section: Introductionmentioning

confidence: 99%

Maternal infections during pregnancy and child cognitive outcomes

Kwok

Hall

Murray

et al. 2022

BMC Pregnancy Childbirth

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Background Maternal prenatal infections have been linked to children’s neurodevelopment and cognitive outcomes. It remains unclear, however, whether infections occurring during specific vulnerable gestational periods can affect children’s cognitive outcomes. The study aimed to examine maternal infections in each trimester of pregnancy and associations with children’s developmental and intelligence quotients. The ALSPAC birth cohort was used to investigate associations between maternal infections in pregnancy and child cognitive outcomes. Methods Infection data from mothers and cognition data from children were included with the final study sample size comprising 7,410 mother-child participants. Regression analysis was used to examine links between maternal infections occurring at each trimester of pregnancy and children’s cognition at 18 months, 4 years, and 8 years. Results Infections in the third trimester were significantly associated with decreased verbal IQ at age 4 (p < .05, adjusted R2 = 0.004); decreased verbal IQ (p < .01, adjusted R2 = 0.001), performance IQ (p < .01, adjusted R2 = 0.0008), and total IQ at age 8 (p < .01, adjusted R2 = 0.001). Conclusion Results suggest that maternal infections in the third trimester could have a latent effect on cognitive development, only emerging when cognitive load increases over time, though magnitude of effect appears to be small. Performance IQ may be more vulnerable to trimester-specific exposure to maternal infection as compared to verbal IQ. Future research could include examining potential mediating mechanisms on childhood cognition, such as possible moderating effects of early childhood environmental factors, and if effects persist in future cognitive outcomes.

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Prenatal maternal infections and children’s socioemotional development: findings from the UK Millennium Cohort Study

Cited by 14 publications

References 43 publications

Maternal use of acetaminophen during pregnancy and neurobehavioral problems in offspring at 3 years: A prospective cohort study

Maternal use of acetaminophen during pregnancy and neurobehavioral problems in offspring at 3 years: A prospective cohort study

Prenatal maternal infections and early childhood developmental outcomes: Analysis of linked administrative health data for Greater Glasgow & Clyde, Scotland

Maternal infections during pregnancy and child cognitive outcomes

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