The Timing of Prenatal Exposure to Maternal Cortisol and Psychosocial Stress Is Associated With Human Infant Cognitive Development

Abstract

The consequences of prenatal maternal stress for infant mental and motor development were examined in 125 full term infants at 3, 6 and12 months of age. Maternal cortisol and psychological state were evaluated five times during pregnancy and at 3, 6 and 12 months postpartum. Exposure to elevated concentrations of cortisol early in gestation was associated with a slower rate of development over the first postnatal year and lower scores on the mental development index of the Bayley Scales of Infant Development (BSID) at 12 months. Elevated levels of maternal cortisol late in gestation, however, were associated with accelerated development over the first year and higher scores on the BSID at 12 months. Elevated levels of maternal pregnancy specific anxiety early in pregnancy were independently associated with lower scores on the BSID at 12 months. These associations could not be explained by postnatal maternal psychological stress, stress related to parenting, prenatal medical history, socioeconomic factors or child race, sex or birth order. These data suggest that maternal cortisol and pregnancy specific anxiety have programming influences on the developing fetus. Prenatal exposure to the same signal, cortisol, had opposite associations with infant development based on the timing of exposure. Keywords pregnancy; cortisol; stress; infant development; cognition; prenatal; depression; anxiety; fetal programmingThe prenatal period is a time of rapid change during which fetal organs and organ systems are forming and are vulnerable to both organizing and disorganizing influences. These influences on the fetus have been described as programming; the process by which a stimulus or insult during a vulnerable developmental period has a long-lasting or permanent effect. The effects of programming are dependent on the timing of the exposure and on the developmental stage of organ systems. There is convincing support for fetal programming of adult health outcomes, however, the evidence comes primarily from retrospective studies that rely on birth phenotype (e.g., small size at birth or preterm delivery) as an index of fetal development (Barker, 1998(Barker, , 2002. It is unlikely, however, that birth phenotype alone is the cause of subsequent health outcomes. Birth phenotype, instead, reflects fetal adaptation to exposures that shape the structure and function of physiological systems that underlie health and disease risk (Gluckman & Hanson, 2004;Morley, Blair, Dwyer, & Owens, 2002 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscriptpurpose of the present study was to investigate the programming influence of biological and psychosocial indicators of prenatal maternal stress for fetal development and to evaluate the effects of timing of exposure to stress on infant development. Fetal Programming: The Role of Glucocorticoids (GCs)For a number of reasons GCs have been proposed as a primary candidate for fetal programming. Glucocorticoids, cortisol in humans, are steroid hormones that play a critical ...

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