Maternal Inflammation, Offspring Neurobehavioral Health, and Perinatal Correlates in the Healthy Start Study

Background: In utero exposure to increased inflammation caused by acute experiences may have a deleterious impact on child neurodevelopment, but little is known about the effects of low-grade chronic inflammation. We wanted to investigate prenatal inflammation, as indicated by biomarkers of low-grade chronic inflammation, as an in utero programming method for neurodevelopment, and see how much of these associations are explained by perinatal factors. Methods: We utilized linear regression to analyze the relationship between prenatal C-reactive protein, interleukin-6, and tumor necrosis factor-α and offspring Child Behavior Check List scores for total issues, externalizing and internalizing behaviors in 489 mother-offspring pairs from the Healthy Start cohort, USA. We made sequential adjustments for perinatal correlates. Model 1 considered maternal age, gestational age at blood draw, and child age. Model 2 included further adjustments for mother race/ethnicity, followed by household income in Model 3 and pre-pregnancy body mass index (BMI) in Model 4. Finally, we used the maternal Edinburgh Postnatal Depression Scale and Perceived Stress Scale scores as measures of psychosocial stress. Results: In Model 1, children of mothers with C-reactive protein in the fourth quartile had a 3.82 (95% CI: 0.94, 6.70) unit higher t-score for total issues compared to those in the first to third quartiles. The inclusion of household income and pre-pregnancy BMI in the fully adjusted model reduced the impact estimate to 3.11 (-0.45, 6.67). We found a similar pattern in externalizing behavior and across models for interleukin 6. Conclusions: Maternal inflammation is linked to worse neurobehavioral outcomes in kids. This association was influenced by higher pre-pregnancy BMI and lower household income.