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

Abstract

Women’s social experiences can have long-term implications for their offspring’s health, but little is known about the potential independent contributions of multiple periods of stress exposures over time. This study examined associations of maternal exposure to adversity in childhood and pregnancy with children’s anxiety and depression symptoms in a large, sociodemographically diverse sample. Participants were 1389 mother-child dyads (child age M = 8.83 years; SD = 0.66; 42% Black, 42% White; 6% Hispanic) in the ECHO-PATHWAYS Consortium’s three U.S. pregnancy cohorts. Women reported their exposure to childhood traumatic events (CTE) and pregnancy stressful life events (PSLE). Children self-reported on their symptoms of anxiety and depression at age 8–9 years. Regression analyses estimated associations between maternal stressors and children’s internalizing problems, adjusting for confounders, and examined child sex as a modifier. Exploratory interaction analyses examined whether geospatially-linked postnatal neighborhood quality buffered effects. In 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. 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.

Prenatal maternal stress: triangulating evidence for intrauterine exposure effects on birth and early childhood outcomes across multiple approaches

“…Our study's observational results suggested an association between prenatal stress exposure and various offspring outcomes: gestational age, birth weight, and emotional and behavioral di culties. This aligns with the ndings of many previous studies (11,12,100,(13)(14)(15)(16)(17)(18)(19)(20). However, results from our analyses challenge any interpretation of these observational ndings as evidence of causal effects (11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

“…This aligns with the ndings of many previous studies (11,12,100,(13)(14)(15)(16)(17)(18)(19)(20). However, results from our analyses challenge any interpretation of these observational ndings as evidence of causal effects (11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Instead, our results are consistent with other studies using genetically informed approaches, which suggest that maternal stressors during pregnancy may not be causally related to developmental outcomes in offspring during preschool years (43)(44)(45)48).…”

“…Several prospective, longitudinal studies have found an association between maternal stress, depression and anxiety and in pregnancy and various emotional and behavioral outcomes in offspring, see e.g., (11)(12)(13)(14)(15)(16)(17)(18)(19)(20). For example, one US study that analyzed data from three different pregnancy cohorts found a relationship between maternal stress during pregnancy and emotional issues in offspring observed at ages 8 to 9 years (15). While many of the studies originate from Europe, North America, and Australia, similar ndings have been reported in other regions (13,(21)(22)(23)(24)(25).…”

Mental health and well-being for the prevention of substance use disorders

“…Evidence from longitudinal cohort studies has highlighted the association between antenatal maternal depressive and anxiety symptoms and infant and child development[ 20 ] and internalizing and externalizing psychopathology. [ 21 , 22 ] These are likely to be mediated by epigenetic changes,[ 23 ] which may influence brain structure and function. [ 24 ] Furthermore, exposure to stressful life events and intimate partner violence during pregnancy is also associated with child executive functioning problems and externalizing problems, a relationship that was moderated by maternal parenting quality, such that higher parenting quality is protective for the associations between stressful life events and outcomes in the child.…”

Prenatal exposures to phthalates and life events stressors in relation to child behavior at age 4–6: A combined cohort analysis

“…Perhaps the most noteworthy limitation of the current literature is the lack of consideration of the potentially powerful role of early life exposure to non-chemical stressors in programming children’s development, particularly mental health. Children born to mothers who experienced more stressful life events during pregnancy (PSLEs) have been found to exhibit more behavioral problems and fearfulness, as well as reduced self-regulation, and these changes can persist into adolescence ( Bergman et al, 2007 ; Bush et al, 2017 ; Bush et al, 2023 ; MacKinnon et al, 2018 ; Noroña-Zhou et al, 2023 ; Tearne et al, 2015 ). Notably, chemical and non-chemical stressors often co-occur, operate through the same mechanistic pathways (e.g., oxidative stress, endocrine disruption, inflammation), and influence the same endpoints (e.g., growth, neurodevelopment, airway health) ( Barrett and Padula 2019 ).…”