Associations between maternal stress during pregnancy and offspring internalizing and externalizing problems in childhood

Abstract

BackgroundMaternal psychological health during pregnancy has been associated with offspring psychopathology. However, it is uncertain whether these associations are mediated by the postpartum depression and related child-rearing factors. Therefore, we examined the associations between prenatal and postnatal factors and internalizing and externalizing behavioral problems in childhood, focusing on maternal psychological health in school-aged children in Korea.FindingsThe current study included 1,003 children (580 boys, 423 girls, mean age 9.05 ± 0.70 years, age range 8–11 years) recruited from schools in five Korean cities. Children’s internalizing and externalizing problems were assessed by the Child Behavior Checklist (CBCL). The parents of the children completed structured questionnaires on perinatal factors. Among 1,003 children, 44 had internalizing problems (IP) and 30 had externalizing problems (EP). When comparing children with IP (n = 44) and without IP (n = 959), severe maternal stress during pregnancy (OR3.36, 95% CI 1.80-6.25) and postpartum depression (OR3.19, 95% CI 1.36-7.53) showed a significant association with the IP. When comparing children with EP (n = 30) and without EP (n = 973), low family income (OR2.19, 95% CI 1.05-4.56), unwanted pregnancy (OR2.76, 95% CI 1.28-5.95) and severe maternal stress during pregnancy (OR2.69, 95% CI 1.29-5.61) with the EP. Only maternal stress during pregnancy was significantly associated with the IP after controlling for postpartum depression and with the EP after controlling for family income and unwanted pregnancy.ConclusionThis study suggests the importance of maternal psychological health during perinatal period on children’s mental health. Further prospective studies in a larger sample are required to confirm our findings.

Maternal infection and stress during pregnancy and depressive symptoms in adolescent offspring

“…In particular, accumulating research suggests that maternal stress during pregnancy is related to childhood cognitive difficulties frequently seen in the histories of depressed populations (Hofstra et al, 2002; Wood et al, 2013), such as lower scores on tests of intellectual functioning and language abilities (Laplante et al, 2008; Slykerman et al, 2005), problems of attention/concentration (Brouwers et al, 2001; Gutteling et al, 2006), and difficultites in academic performance (Niederhofer and Reiter, 2004). Additionally, prenatal maternal stress has been associated with increases in offspring behavioral/emotional problems during childhood that are linked to risk of later depression (Zahn-Waxler et al, 2000), such as childhood anixety (Davis and Sandman, 2012; Loomans et al, 2011), parental report of behavioral maladjustment (Gutteling et al, 2005; O'Connor et al, 2002), internalizing problems (Howland et al, 2016; Park et al, 2014), and temperaments associated with increased frustration, crying, and negative reactivity (Davis et al, 2007; Gutteling et al, 2005; Werner et al, 2007). Evidence also suggests sex differences in fetal exposure to prenatal stress with females showing an increased risk for later affective problems compared to males, following fetal exposure to maternal stress (Quarini et al, 2016; Sandman et al, 2013).…”

Use of Archived Neonatal Bloodspots for Examining Associations between Prenatal Exposure to Potentially Traumatic or Stressful Life Events, Maternal Herpesvirus Infection and Lifetime History of Generalized Anxiety Disorder in Offspring

“…While we were underpowered to detect statistically significant associations between maternal experience of PTEs or SLEs during pregnancy and offspring GAD due to limited sample size, effect estimates observed in our study were in the expected direction. Indeed, several other studies that have identified a positive association between maternal trauma or stress during pregnancy and anxiety disorders in offspring during childhood (Najman et al, 2010;Davis and Sandman, 2012;Betts et al, 2014;Park et al, 2014). For example, Davis et al recently examined the association between maternal perceived stress during pregnancy and offspring anxiety at ages 6 and 9 assessed via the Anxiety Problems subscale of the Child Behavior Checklist (CBC) among a longitudinal cohort of 178 mother-child pairs recruited from obstetric clinics in Southern California (Davis and Sandman, 2012).…”

“…While much research has focused on the role that early life trauma plays in the development of anxiety disorders among children (Stein et al, 1996;Pynoos et al, 1999;Heim and Nemeroff, 2001;Hovens et al, 2010Hovens et al, , 2012Hovens et al, , 2015Lochner et al, 2010;Klauke et al, 2011;Kuo et al, 2011;Zikic et al, 2015), a growing body of studies suggest that the adverse effects of traumatic events as well as other stressors on the development of anxiety disorders in children may begin before birth (Yehuda et al, 2001;Najman et al, 2010;Rice et al, 2010;Davis and Sandman, 2012;Betts et al, 2014;Park et al, 2014). Researchers have hypothesized that excess exposure to maternal stress hormones during gestation plays a key role in fetal programming of offspring anxiety disorders via causing permanent alterations to hypothalamic-pituitary-adrenal (HPA) axis function and/or via contributing to epigenetic modifications that adversely shape offspring stress reactivity (Weaver et al, 2004;Skinner et al, 2008;Glover et al, 2010;Davis et al, 2011;Radtke et al, 2011;Perroud et al, 2014).…”

Paternal involvement and early infant neurodevelopment: the mediation role of maternal parenting stress

“…Until now, studies on the effects of parenting have focused on maternal aspects [1–5]. For example, many studies have suggested that antenatal and postnatal maternal depression negatively affects children’s cognitive and psychosocial development [1–4].…”

“…For example, many studies have suggested that antenatal and postnatal maternal depression negatively affects children’s cognitive and psychosocial development [1–4]. Maternal parenting stress directly influences infant development, has a negative effect on parenting behavior, and delays stable attachment between parent and child [6, 7].…”