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J Child Psychol Psychiatry. 2018 Jul;59(7):801-810. doi: 10.1111/jcpp.12856. Epub 2017 Dec 26.

Childhood developmental vulnerabilities associated with early life exposure to infectious and noninfectious diseases and maternal mental illness.

Green MJ1,2, Kariuki M1,2, Dean K1,2,3, Laurens KR1,4, Tzoumakis S1,2,5, Harris F1,2, Carr VJ1,2,6.

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School of Psychiatry, University of New South Wales, UNSW Sydney, Sydney, NSW, Australia.
Neuroscience Research Australia, Sydney, NSW, Australia.
Justice Health & Forensic Mental Health Network, Sydney, NSW, Australia.
School of Psychology, Australian Catholic University, Brisbane, QLD, Australia.
School of Social Sciences, University of New South Wales, Sydney, NSW, Australia.
Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, Vic., Australia.



Fetal exposure to infectious and noninfectious diseases may influence early childhood developmental functioning, on the path to later mental illness. Here, we investigated the effects of in utero exposure to maternal infection and noninfectious diseases during pregnancy on offspring developmental vulnerabilities at age 5 years, in the context of estimated effects for early childhood exposures to infectious and noninfectious diseases and maternal mental illness.


We used population data for 66,045 children from an intergenerational record linkage study (the New South Wales Child Development Study), for whom a cross-sectional assessment of five developmental competencies (physical, social, emotional, cognitive, and communication) was obtained at school entry, using the Australian Early Development Census (AEDC). Child and maternal exposures to infectious or noninfectious diseases were determined from the NSW Ministry of Health Admitted Patients Data Collection (APDC) and maternal mental illness exposure was derived from both APDC and Mental Health Ambulatory Data collections. Multinomial logistic regression analyses were used to examine unadjusted and adjusted associations between these physical and mental health exposures and child developmental vulnerabilities at age 5 years.


Among the physical disease exposures, maternal infectious diseases during pregnancy and early childhood infection conferred the largest associations with developmental vulnerabilities at age 5 years; maternal noninfectious illness during pregnancy also retained small but significant associations with developmental vulnerabilities even when adjusted for other physical and mental illness exposures and covariates known to be associated with early childhood development (e.g., child's sex, socioeconomic disadvantage, young maternal age, prenatal smoking). Among all exposures examined, maternal mental illness first diagnosed prior to childbirth conferred the greatest odds of developmental vulnerability at age 5 years.


Prenatal exposure to infectious or noninfectious diseases appear to influence early childhood physical, social, emotional and cognitive developmental vulnerabilities that may represent intermediate phenotypes for subsequent mental disorders.


CNS ; Risk factors; developmental epidemiology; developmental psychopathology; infection; maternal factors


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