Poster #14 - Maternal sensitivity and childhood home environment modify associations between prenatal stress and child mental health

• In Event: Poster Session 04

Abstract

Background: The prenatal period is characterized by a rate of fetal growth unparalleled by other developmental periods as well as heightened fetal sensitivity to environmental inputs. Fetal exposure to maternal stress and distress is associated with greater risk for mental and physical health problems across development. Of note, emerging evidence indicates that postnatal environmental factors, such as maternal positive engagement and sensitivity, protect against risk for cognitive delays among offspring exposed to prenatal stress. Further research in this area is critical to inform targets for prevention and intervention in early childhood. The current study evaluates whether maternal sensitivity and home environment quality modify the association between prenatal stress and child mental health in childhood.

Methods: Participants in this study were 127 mother-child pairs enrolled in a multi-site investigation on preconception and prenatal predictors of child outcomes. About half of mothers identified as Hispanic/Latina (48.8%). Average per capita household was $12,604 (SD = $12,725). Mothers completed measures of depressive symptoms and perceived stress in the second and third trimester. Prenatal stress was operationalized as a standardized composite of depressive symptoms and perceived stress. Maternal sensitivity was rated during a parent-child free play task when children were 3.85 years of age (SD = 0.52; 53.5% girls). Mothers reported on home environment quality using the Home Screening Questionnaire and child internalizing and externalizing behaviors with the Child Behavior Checklist approximately one year later (Mage = 5.08, SDage = 0.53). Multiple linear regression models with interactive terms were used to test research questions, adjusting for income, relationship status, birth order, maternal age, and concurrent maternal psychological distress.

Results: In bivariate associations, prenatal stress was associated with more internalizing behaviors whereas higher maternal sensitivity and home environment quality were associated with fewer internalizing and externalizing behaviors (Table 1). The association between prenatal stress and child internalizing behaviors was moderated by maternal sensitivity (beta [95% CI]=-0.195 [-0.377, -0.000]) and the home environment (beta [95% CI]=-0.218 [-0.412, -0.011]). There was a stronger, positive association between prenatal stress and internalizing behaviors at low home environment quality or maternal sensitivity but no association between prenatal stress and internalizing behaviors at average or high home environment quality or maternal sensitivity (Figure 1). There was no interactive effect of prenatal stress and maternal sensitivity or the home environment on externalizing behaviors; however, higher maternal sensitivity and a more enriching home environment was associated with fewer externalizing problems (maternal sensitivity beta [95% CI]=-0.255 [-0.436, -0.051], home environment beta [95% CI]=-0.291 [-0.490, -0.070]).

Conclusions: The prenatal environment sets probabilistic parameters for development, but the postnatal environment may modify the extent to which prenatal stress predicts offspring outcomes. The results of the current study add to growing evidence that an early childhood environment characterized by high maternal sensitivity and the availability of cognitive stimulation and emotional support in the home may protect against child mental health problems following prenatal stress. Prevention and intervention focused on quality of the caregiving environment in early childhood may ameliorate effects of prenatal stress and promote child mental health.

Authors

• Gabrielle Rose Rinne, University of California - Los Angeles
  Presenting Author

• Mallory Podosin, University of California, Los Angeles

• Madeleine U. Shalowitz, NorthShore University HealthSystem

• Sharon Landesman Ramey, Virginia Polytechnic Institute and State University

• Chris Dunkel Schetter, University of California - Los Angeles