Guided by teratology, attachment, and stress theories, this cross-sectional secondary dataset analysis examined relationships between prenatal exposure to risk and pre-adoptive placement on behavior problems, self-regulation, and stress response modulation in 6-7 year old children of ICA. Early care comparisons were made between three groups matched on age at assessment (m = 6.9 years; SD = 0.6) and gender (girls n/group = 30) in children reared in institutional care (IC) (n = 40; m adoption age = 19 months; SD= 6.7 months), foster care (FC) (n = 40; m adoption age = 8.0 months; SD = 5.3), or birth family care (BC) (n = 40). Prenatal risk comparisons were made between the IC and FC groups; children were exposed to low (0 or 1) or high (2-3) prenatal risks (global measure of alcohol, malnutrition, and/or prematurity). Adoptive parents provided child/family demographics, historical adoption and known prenatal risk information, completed behavior and temperament scales, and collected home baseline salivary cortisol samples. In the lab, children were tested on inhibitory control, attention regulation, and salivary cortisol sampling. Analysis of Variance (ANOVA), independent samples t-tests, and Analysis of Covariance (ANCOVA) tested the individual effects of prenatal risk and early care on outcomes. Two-way ANCOVAs were used to investigate whether early care moderated prenatal risk on children’s outcomes when controlling for adoption age. For type of early care, results indicated significant differences between groups on behavior problems (IC > BC), self-regulation (IC < BC) and lab cortisol baseline (IC < FC), but only without controlling for adoption age. When comparing high and low prenatal risk on child outcomes, high prenatal risk denoted greater behavior problems and elevated home cortisol baseline results, even when controlling for adoption age and early care type. Early care type did not moderate the prenatal risk effects on the study’s developmental outcomes, indicating that, at least in this sample, the effects of prenatal risk were strong. Further implications include the need for further investigation of effects of prenatal risk and institutional care risk on ICA children’s developmental outcomes as well as collaborative research between social work, neuroscience, and stress researchers.