Abnormal sex hormone levels in utero have been associated with child behavioral problems, but it is unclear if normal variation in prenatal sex hormones is associated with subsequent behavior in childhood. We assessed maternal sex hormones, including serum estrone (E1), estradiol (E2), estriol (E3), free testosterone (FT), and total testosterone (TT), during early pregnancy (gestational week 6-21 (mean = 11.1)) and evaluated child behavior at ages 4-5 using the Behavioral Assessment System for Children (BASC-2) and Social Responsiveness Scale (SRS-2) in 404 mother/child pairs (211 girls, 193 boys) within The Infant Development and Environment Study, a multi-site pregnancy cohort study. Associations between hormones and composite scores were evaluated using multiple linear regressions in both sexes combined, and separate models assessed effect modification by sex with the addition of interaction terms. A 10-fold increase in maternal FT or TT was associated in both sexes with a 4.3-point (95 % CI: 0.5, 8.2) or 4.4-point (0.8, 8.0) higher BASC-2 internalizing composite T score, respectively. In addition, a 10-fold increase in FT or TT was associated with a 3.8-point (0.04, 7.5) or 4.0-point (0.5, 7.5) higher behavioral symptoms index composite score. In models evaluating effect modification by sex, a 10-fold increase in E1 was associated with a 4.3-point (1.2, 7.4) decrease in adaptive skills composite score in girls only (interaction p = 0.04). We observed associations between testosterone and internalizing behaviors and behavioral symptoms index in both sexes, as well as a female-specific association between E1 and adaptive skills. Sex hormones during pregnancy may play a key role in influencing later-life behavior, and additional studies should further examine different periods of susceptibility to hormonal signals.

中文翻译：

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儿童产前性激素和行为结果

子宫内异常的性激素水平与儿童行为问题有关，但尚不清楚产前性激素的正常变化是否与儿童随后的行为有关。我们评估了孕早期（妊娠 6-21 周（平均 = 11.1））的母体性激素，包括血清雌酮 (E1)、雌二醇 (E2)、雌三醇 (E3)、游离睾酮 (FT) 和总睾酮 (TT) ) 并使用儿童行为评估系统 (BASC-2) 和社会反应量表 (SRS-2) 在婴儿发展和环境中的 404 对母婴（211 名女孩，193 名男孩）中评估了 4-5 岁的儿童行为研究，一项多地点妊娠队列研究。使用两种性别的多元线性回归来评估激素和综合评分之间的关​​联，单独的模型通过添加交互项来评估按性别进行的效果修改。母体 FT 或 TT 增加 10 倍与两种性别的 BASC-2 内化综合 T 评分分别高 4.3 点（95 % CI：0.5、8.2）或 4.4 点（0.8、8.0）相关。此外，FT 或 TT 增加 10 倍与行为症状指数综合评分提高 3.8 点（0.04、7.5）或 4.0 点（0.5、7.5）相关。在评估性别效应修正的模型中，E1 增加 10 倍与仅女孩的适应性技能综合得分下降 4.3 点（1.2、7.4）相关（交互 p = 0.04）。我们观察到两种性别的睾酮与内化行为和行为症状指数之间的关联，以及 E1 与适应性技能之间的女性特异性关联。