BACKGROUND It has been suggested that prenatal maternal stress may increase the risk of childhood externalizing disorders, yet no large cohort study has investigated this association across a large range of acute stressors. Our objective was to estimate the association between prenatal stressful events and risk of offspring conduct disorder and hyperactivity. METHODS We used data from 10,184 mother-offspring pairs from the United Kingdom-based Avon Longitudinal Study of Parents and Children. Mothers self-reported 42 prenatal stressful life events at 18 weeks' gestation. Symptoms of conduct disorder and hyperactivity in their offspring were measured at 6, 9, 11, 13, and 16 years of age using the Strengths and Difficulties Questionnaire. The primary outcome was membership in high-symptom trajectories of 1) conduct disorder and 2) hyperactivity throughout childhood, identified using latent class growth modeling. Multinomial logistic regression models estimated the association between prenatal stress and both conduct disorder and hyperactivity, after adjusting for sex, parental education, low birth weight, preterm birth, parental social class, maternal smoking and drinking, maternal mental health, offspring stressful life events, and offspring depressive and anxious symptoms. RESULTS Those exposed to the highest quartile of prenatal stress were more likely to belong to the high symptom trajectory for hyperactivity (B = 0.46, p < .05) and conduct disorder (B = 0.88, p < .01), respectively. Prenatal stress further demonstrated a positive, dose-response relationship with symptoms of externalizing disorders at independent time points. CONCLUSIONS The findings suggest that prenatal stressful events may be an independent risk factor for offspring externalizing symptoms, regardless of maternal mental health and offspring internalizing.

中文翻译：

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产前压力与童年外化症状之间的关联：来自雅芳父母和儿童纵向研究的证据

背景 有人提出，产前母亲压力可能会增加儿童外化障碍的风险，但没有大型队列研究调查了大量急性压力源之间的这种关联。我们的目标是估计产前压力事件与后代品行障碍和多动症风险之间的关联。方法 我们使用了来自英国雅芳父母和儿童纵向研究的 10,184 对母子对的数据。母亲在妊娠 18 周时自我报告了 42 次产前压力性生活事件。使用优势和困难问卷在 6、9、11、13 和 16 岁时测量其后代的品行障碍和多动症状。主要结果是 1) 品行障碍和 2) 整个儿童期的多动症的高症状轨迹的成员资格，使用潜在类别增长模型确定。多项逻辑回归模型估计产前压力与品行障碍和多动之间的关联，在调整性别、父母教育、低出生体重、早产、父母社会阶层、母亲吸烟和饮酒、母亲心理健康、后代压力生活事件后，和后代的抑郁和焦虑症状。结果 那些暴露于最高四分位数产前压力的人更有可能分别属于多动 (B = 0.46, p < .05) 和品行障碍 (B = 0.88, p < .01) 的高症状轨迹。产前压力进一步显示出积极的、在独立时间点与外化障碍症状的剂量反应关系。结论 研究结果表明，产前压力事件可能是后代外化症状的独立危险因素，与母亲的心理健康和后代内化无关。