Associations of Prenatal Stress with Executive Functions at 5 Years of Age

• In Event: Executive functions across diverse contexts

Abstract

By age 5 years, deficits in executive functions (EF), the set of cognitive abilities needed for carrying out goal-directed behavior, are a transdiagnostic indicator of atypical development and an important predictor of psychosocial functioning across the life span. Prenatal stress (PS), including maternal mental health problems and perceived stress during pregnancy, is likely to be an important predictor of individual differences in children’s EF as it is associated with alterations in the neurobiology underlying EF. While a negative effect of PS on EF in middle childhood (ages 6 to 12 years) has been documented, only two studies have examined this association in early childhood, and results of these studies are mixed. The present study examined associations of PS with children’s EF at age 5 years.

Mothers were originally recruited from high-risk prenatal clinics to participate in a general-purpose Perinatal Research Repository, and followed longitudinally from pregnancy. At enrollment, mothers completed a demographic questionnaire and reported whether they used substances during pregnancy. During both their second and third trimesters, mothers completed five self-report questionnaires used as the measures of PS. The questionnaires assessed trait anxiety, perceived stress, sleep quality, everyday discrimination, and depression. Scores on the measures were correlated (rs = .33 – .84) so we created a composite score capturing PS over both trimesters. When children were between the ages of 3.5 and 7 years, families (N = 365) were recontacted to participate in a study of the effects of lifestyle factor exposure during pregnancy on child development. One hundred and forty-two children (61 girls, 81 boys) and their mothers participated in a follow-up visit when children were 5 years old. At this visit, children completed an EF assessment battery that included the Tower of Hanoi and the Flanker, Dimensional Change Card Sort (DCCS), Pattern Comparison, and List Sorting Working Memory tasks from the NIH Toolbox. Mothers completed the NIH Toolbox, which includes measures of fluid and crystallized intelligence.

Structural equation modelling was conducted using MPlus. Confirmatory factor analysis was used to establish the structure of EF. Regression was used to examine whether PS predicted EF. Maternal race and ethnicity; marital status; education; substance use during pregnancy; and fluid intelligence were included as covariates in all analyses.

Consistent with previous research, confirmatory factor analysis supported a one-factor model of EF including the Tower of Hanoi, Flanker, DCCS, and Pattern Comparison tasks. Higher PS was associated with poorer EF (Figure 1). Of the covariates, only maternal higher fluid intelligence was significantly associated with better child EF (b = -.03, p < .001).

This study examined the association of PS with EF in early childhood. Higher PS was associated with poorer EF. This result extends findings regarding the detrimental effects of PS on children’s EF to a younger age group. Critically, early childhood is when EF is most amenable to intervention. The present findings of an early emerging association between PS and EF suggests that children exposed to high levels of PS may benefit from early childhood interventions to improve EF.

Authors

• Daphne Vrantsidis, University of Calgary (U of C)
  Presenting Author

• Mark Klebanoff

• Keith O Yeates, University of Calgary

• Aaron Murnan

• Peter Fried

• Kelly Boone, Ohio State University

• Joseph Rausch

• Sarah Keim, The Research Institute at Nationwide Children’s Hospital