A Multi-Cohort Examination of the Independent Contributions of Maternal Childhood Adversity and Pregnancy Stressors to Children’s Anxiety and Depression

• In Event: Intergenerational and Developmental Origins of Health: Maternal Prenatal Distress and Implications for Offspring Psychopathology

Abstract

Background: Experiences of stress and adversity during sensitive periods of development, such as the fetal, childhood, and pregnancy periods, may have especially enduring impacts on health. Accumulating work suggests that these impacts may span generations and play an important role in the development of children’s behavioral and emotional health outcomes. While a sizeable evidence base demonstrates heightened offspring psychopathology risk secondary to maternal exposure to stress during pregnancy, more recently, research has shown that this intergenerational cascade of stress effects may extend back to maternal childhood exposures as well. Objectives of the current study were to: a) examine unique associations between maternal exposure to adversities during childhood and pregnancy and offspring’s anxiety and depression symptoms at age 8-9, and b) determine whether these associations differed by child biological sex or neighborhood quality.

Method: Participants were 1389 sociodemographically diverse mother-child dyads (child age M=8.83 years; SD=0.66; 42% Black, 42% White; 6% Hispanic) in the (anonymized) Consortium’s three pregnancy cohorts from six U.S. geographic regions. Women reported on their exposure to childhood traumatic events (CTE) and pregnancy stressful life events (PSLE). Children self-reported on their symptoms of anxiety (SCARED) and depression (CDI-2) at age 8-9 years. Regression analyses estimated associations between maternal stressors and children’s internalizing problems and examined child sex and geospatially-linked postnatal neighborhood quality (Childhood Opportunity Index) as moderators. Primary models adjusted for a wide range of confounders, including study site; household regional/family-size-adjusted income, child age, biological sex, race and ethnicity; maternal age at enrollment, pre-pregnancy BMI, level of education, and parity.

Results: Bivariate models indicated that maternal CTE was positively associated with child depression symptoms, and PSLE positively associated with both child anxiety symptoms and depression symptoms. However, in confounder-adjusted models, PSLE counts positively predicted levels of children’s anxiety and depression symptoms ([ßAnxiety=0.08, 95%CI [0.02, 0.13]; ßDepression=0.09, 95%CI [0.03, 0.14]); no significant associations were observed with CTE. Each additional PSLE increased odds of clinically significant anxiety symptoms by 9% (95%CI [0.02, 0.17]). Neither sex nor neighborhood quality moderated relations.

Conclusions: Maternal stressors during pregnancy appear to have associations with middle childhood anxiety and depression across diverse sociodemographic contexts, whereas maternal history of childhood adversity may not. Effects appear comparable for boys and girls. Policies and programs addressing prevention of childhood internalizing symptoms may benefit from considering prenatal origins and the potential two-generation impact of pregnancy stress prevention and intervention.

Author

• Amanda Norona-Zhou, University of California - San Francisco
  Presenting Author