Maternal Multi-Domain Prenatal Stress is Associated with Offspring Socioemotional Functioning

• In Event: Moderators and Protective Factors for Pre- and Post-natal Maternal Distress Associations with Child Neurodevelopmental Outcomes

Abstract

Background and Objectives: The Developmental Origins of Health and Disease framework posits that child neurodevelopment is shaped by maternal risk factors - particularly stress during gestation. However, stress can take many forms across multiple levels of analysis, including maternal childhood adversity, socioeconomic adversity, and various stressors during pregnancy; yet few studies have examined simultaneous contribution of multiple forms of stress. Research also suggests that malleable, environmental factors, such as social support and parenting knowledge, can be protective for later child neurodevelopment. Using a large, diverse sample of mother-infant dyads, we examined whether multiple dimensions of maternal stress were negatively associated with child socioemotional and behavioral development at age one, and whether prenatal maternal social support and knowledge of infant development would buffer infants from these risks.

Methods: The Conditions Affecting Neurocognitive Development and Learning and Early Childhood (CANDLE) study is a large, diverse (66% African American, 44% White), longitudinal pregnancy cohort, representative of the urban Southern metropolitan area. Information was collected during pregnancy, at 4-weeks, and 1-year post-birth on 1127 mother-child dyads. Exposures included maternal childhood trauma, socioeconomic (SES) risk, intimate partner violence (IPV) during pregnancy, and objectively measured, geocode-linked neighborhood violence during pregnancy. Child socioemotional and behavior problems were measured with the Brief Infant Toddler Social and Emotional Assessment (BITSEA) at age-one. During pregnancy, maternal social support was measured using the Social Support Questionnaire (SSQ) and parenting knowledge was measured with the Knowledge of Infant Development Inventory (KIDI). Covariates included maternal age, race, marital status, postpartum depression (at 4 weeks), child sex, and child age.

Results: We utilized multivariate regression models to first examine the main effects between the four stress exposures and child socioemotional problems. We then examined potential moderation effects by maternal knowledge of infant development and social support on child socioemotional problems. In covariate-adjusted models, maternal childhood trauma (β=0.06, p=.043), SES risk (β=0.16, p<.001), and IPV (β=0.08, p=.012) were uniquely associated with increased child socioemotional problems at age-one. Neighborhood violence did not reach significance (β=.06, p=.112) in adjusted models. Maternal parenting knowledge significantly moderated the effect of both maternal childhood trauma (β=0.06, p=.042) and SES risk (β=0.09, p=.020) on child problems: greater knowledge of infant development attenuated the association between both maternal childhood trauma and SES risk on child socioemotional problems, such that the risks were buffered for those with average or better parenting knowledge. Maternal prenatal social support did not significantly moderate the associations between any exposure variables and child problems, however, in parallel to the pattern found with parenting knowledge, trend-level associations were found with SES (β=0.06, p=.094) and IPV (β=-0.06, p=.071).

Conclusions: Findings from this large, diverse sample suggest that multiple dimensions of maternal prenatal stress are associated with increased risk for child socioemotional/behavioral problems early in life, in a cumulative fashion. Findings also suggest that malleable environmental factors, such as parenting knowledge related to child development, might mitigate these risks for child wellbeing. Opportunities for early screening and intervention with families to promote child socioemotional wellbeing are discussed.

Authors

• Shaikh I. Ahmad, University of California - San Francisco
  Presenting Author

• Kristen L Rudd, University of California - San Francisco
  Non-Presenting Author

• Kaja Z. LeWinn, University of California, San Francisco
  Non-Presenting Author

• Sheela Sathyanarayana, University of Washington
  Non-Presenting Author

• Catherine J. Karr, University of Washington
  Non-Presenting Author

• W. Alex Mason, The University of Tennessee Health Science Center
  Non-Presenting Author

• Frances Tylavsky, The University of Tennessee Health Science Center
  Non-Presenting Author

• Nicole R Bush, University of California - San Francisco
  Non-Presenting Author