{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T06:20:34Z","timestamp":1790490034905,"version":"4.1.0"},"reference-count":79,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH101425, R01MH124694"],"award-info":[{"award-number":["R01MH101425, R01MH124694"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005294","name":"Massachusetts General Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005294","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH113930"],"award-info":[{"award-number":["R01MH113930"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"name":"David Judah Fund"},{"DOI":"10.13039\/100012213","name":"Rappaport Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012213","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ammon-Pinizzoto Center for Women's Health"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Numerous adverse prenatal exposures have been individually associated with risk for psychiatric illness in the offspring. However, such exposures frequently co-occur, raising questions about their cumulative impact. We evaluated effects of cumulative adverse prenatal exposure burden on psychopathology risk in school-aged children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using baseline surveys from the U.S.-based Adolescent Brain and Cognitive Development (ABCD) Study (7,898 non-adopted, unrelated children from 21 sites, age 9\u201310, and their primary caregivers), we examined 8 retrospectively-reported adverse prenatal exposures in relation to caregiver-reported total and subscale Child Behavior Checklist (CBCL) scores. We also assessed cumulative effects of these factors on CBCL total as a continuous measure, as well as on odds of clinically significant psychopathology (CBCL total \u226560), in both the initial set and a separate ABCD sample comprising an additional 696 sibling pairs. Analyses were conducted before and after adjustment for 14 demographic and environmental covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In minimally and fully adjusted models, 6 exposures (unplanned pregnancy; maternal alcohol, marijuana, and tobacco use early in pregnancy; pregnancy complications; and birth complications) independently associated with significant but small increases in CBCL total score. Among these 6, none increased the odds of crossing the threshold for clinically significant symptoms by itself. However, odds of exceeding this threshold became significant with 2 exposures (OR = 1.86, 95% CI 1.47\u20132.36), and increased linearly with each level of exposure (OR = 1.39, 95% CI 1.31\u20131.47), up to 3.53-fold for \u22654 exposures versus none. Similar effects were observed in confirmatory analysis among siblings. Within sibling pairs, greater discordance for exposure load associated with greater CBCL total differences, suggesting that results were not confounded by unmeasured family-level effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Children exposed to multiple common, adverse prenatal events showed dose-dependent increases in broad, clinically significant psychopathology at age 9\u201310. Fully prospective studies are needed to confirm and elaborate upon this pattern.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0250235","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T13:38:07Z","timestamp":1619617087000},"page":"e0250235","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":51,"title":["Association of adverse prenatal exposure burden with child psychopathology in the Adolescent Brain Cognitive Development (ABCD) Study"],"prefix":"10.1371","volume":"16","author":[{"given":"Joshua L.","family":"Roffman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eren D.","family":"Sipahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5609-7727","authenticated-orcid":true,"given":"Kevin F.","family":"Dowling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan E.","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3307-9694","authenticated-orcid":true,"given":"Casey E.","family":"Hopkinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamdi","family":"Eryilmaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee S.","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodi","family":"Gilman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alysa E.","family":"Doyle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin C.","family":"Dunn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,4,28]]},"reference":[{"issue":"4","key":"pone.0250235.ref001","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.biopsych.2010.05.028","article-title":"Early life programming and neurodevelopmental disorders","volume":"68","author":"TL Bale","year":"2010","journal-title":"Biol Psychiatry"},{"issue":"3","key":"pone.0250235.ref002","doi-asserted-by":"crossref","first-page":"e12447","DOI":"10.1111\/gbb.12447","article-title":"Post-GWAS in Psychiatric Genetics: A Developmental Perspective on the \"Other\" Next Steps","volume":"17","author":"DM Dick","year":"2018","journal-title":"Genes Brain Behav"},{"issue":"9","key":"pone.0250235.ref003","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/S1357-4310(95)90793-9","article-title":"Intrauterine programming of adult disease","volume":"1","author":"DJ Barker","year":"1995","journal-title":"Mol Med Today"},{"issue":"8489","key":"pone.0250235.ref004","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1016\/S0140-6736(86)91340-1","article-title":"Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales","volume":"1","author":"DJ Barker","year":"1986","journal-title":"Lancet"},{"issue":"2","key":"pone.0250235.ref005","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1097\/MOP.0000000000000596","article-title":"The importance of cohort research starting early in life to understanding child health","volume":"30","author":"N Paneth","year":"2018","journal-title":"Curr Opin Pediatr"},{"issue":"1","key":"pone.0250235.ref006","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1001\/archpsyc.1996.01830010027005","article-title":"Schizophrenia after prenatal famine. 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