Preconception maternal posttraumatic stress and child negative affectivity: Prospectively evaluating the intergenerational impact of trauma

Abstract

The developmental origins of psychopathology begin before birth and perhaps even prior to conception. Understanding the intergenerational transmission of psychopathological risk is critical to identify sensitive windows for prevention and early intervention. Prior research demonstrates that maternal trauma history, typically assessed retrospectively, has adverse consequences for child socioemotional development. However, very few prospective studies of preconception trauma exist, and the role of preconception symptoms of posttraumatic stress disorder (PTSD) remains unknown. The current study prospectively evaluates whether maternal preconception PTSD symptoms predict early childhood negative affectivity, a key dimension of temperament and predictor of later psychopathology. One hundred and eighteen women were recruited following a birth and prior to conception of the study child and were followed until the study child was 3–5 years old. Higher maternal PTSD symptoms prior to conception predicted greater child negative affectivity, adjusting for concurrent maternal depressive symptoms and sociodemographic covariates. In exploratory analyses, we found that neither maternal prenatal nor postpartum depressive symptoms or perceived stress mediated this association. These findings add to a limited prospective literature, highlighting the importance of assessing the mental health of women prior to conception and providing interventions that can disrupt the intergenerational sequelae of trauma.

Maternal stress and mental health before pregnancy and offspring diurnal cortisol in early childhood

“…For example, children of parents with PTSD are at higher risk of PTSD (Leen-Feldner et al, 2013;Scheeringa & Zeanah, 2001;. Concurrent work in this cohort reports that prepregnancy maternal PTSD symptoms are associated with greater child negative affectivity in early childhood (Swales et al, 2022) factors may also contribute. For example, the transition to kindergarten typically occurs around the age of 5 years and may lead to changes in daily routine that affect wake time, morning routine, levels of stress, and diurnal cortisol patterns in children (Bruce et al, 2002;Quas et al, 2002).…”

“…For example, children of parents with PTSD are at higher risk of PTSD (Leen‐Feldner et al., 2013; Scheeringa & Zeanah, 2001; Yehuda & Bierer, 2007). Concurrent work in this cohort reports that prepregnancy maternal PTSD symptoms are associated with greater child negative affectivity in early childhood (Swales et al., 2022). Blunted diurnal cortisol may be indicative of psychological differences in mental health risk or may serve as a mechanism underlying the intergenerational effects of traumatic experiences.…”

“…Prior work in the larger CCHN cohort provided further validation of this measure by documenting an association between PCL‐C scores and past‐year trauma burden (Thomas et al., 2021). Consistent with prior research, a cut‐off score of 30 was used to indicate clinically elevated symptoms and a probable diagnosis of PTSD (Swales et al., 2022), and 13 participants (20.31%) met criteria for clinically elevated symptoms. The PCL‐C demonstrated excellent internal consistency in the present sample ( α = .91).…”

“…Studies using animal models have experimentally elevated preconception maternal stress exposure, while controlling for further stress during pregnancy, and detected adverse neurodevelopmental outcomes in offspring (see Keenan et al., 2018 for a review). In humans, preconception maternal stress and mental health symptoms have been associated with adverse outcomes in infancy and childhood, including higher incidence or risk of sleep disturbances (Baird et al., 2009), emotional reactivity (Spry et al., 2020), negative affectivity (Swales et al., 2022), behavior problems (Letcher et al., 2020), and attention‐deficit/hyperactivity disorder in males (J. Li et al., 2010). Studies of maternal mental health and stress prior to conception can provide insights about the long‐term effects on offspring, with potential implications for screening and treatment in individuals prior to and during pregnancy.…”

Canada’s Colonial Genocide of Indigenous Peoples: A Review of the Psychosocial and Neurobiological Processes Linking Trauma and Intergenerational Outcomes

“…Stressors encountered by women prior to becoming pregnant can affect offspring birth weight [ 103 ], fetal brain development, and postnatal psychological disorders [ 104 ], which could potentially come about due to the distress related to persistent negative rumination. A prospective analysis similarly revealed that preconception PTSD was associated with elevated negativity when children were 3–5 years old, even after controlling for prenatal and postnatal depressive symptoms or sociodemographic factors [ 105 ].…”