News Release

NIH study suggests maternal inflammation risk factors associated with children's behavioral and emotional regulation

Peer-Reviewed Publication

Environmental influences on Child Health Outcomes

Maternal inflammation risk factors may be associated with dysregulation in children, according to a study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health. “Dysregulation” in this context refers to children’s attention, anxiety and depression, and aggression being measurably different from what is typically expected at their age. 

While inflammation is a normal bodily response to injury or infection, ECHO investigators wanted to learn whether factors linked to inflammation during pregnancy might be associated with dysregulation in children.

More youth with dysregulation (35%) were born to mothers with prenatal infections compared with 28% of youth without dysregulation. Other maternal factors studied, including being overweight before pregnancy, attaining less education, and smoking during pregnancy, were associated with higher likelihoods of childhood dysregulation. Children and adolescents who had a parent or sibling with a mental health disorder were also more likely to experience dysregulation.

“Addressing factors and treating conditions associated with behavior challenges may help improve outcomes for these children,” said Jean Frazier, MD, of the University of Massachusetts Chan Medical School and a leader of the study.

Researchers used the Child Behavior Checklist (CBCL) to measure aggressive behavior, anxiety/depression, and attention problems in children. Approximately 13.4 % of children and adolescents in the study met the criteria for the CBCL Dysregulation Profile.

This study included 4,595 participants (ages 6-18 years) from 18 ECHO research sites across the United States.

Dr. Frazier and Mike O’Shea, MD, of the University of North Carolina at Chapel Hill led this collaborative research published in the Journal of the American Academy of Child and Adolescent Psychiatry.


About ECHO: Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit



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