Prospective Relations Between Prenatal Maternal Cortisol and Child Health Outcomes.

Author: Roettger ME, et al. (2019), Psychosom Med.

OBJECTIVE: To investigate prospective, longitudinal associations between maternal prenatal cortisol response to an interpersonal stressor and child health over the subsequent three years.

METHODS: 123 women expecting their first child provided salivary cortisol samples between 12-32 weeks gestation (M=22.4±4.9 weeks) before and after a videotaped couple conflict discussion with their partner. Mothers reported on overall child health and several indicators of child illness (sick doctor visits, fevers, ear and respiratory infections) when children were 6 months (n=114), 1 (n=116) and 3 (n=105) years old. Associations between maternal prenatal cortisol reactivity and recovery and later child health at each of the three time points were analyzed using longitudinal regression models.

RESULTS: Greater cortisol reactivity in response to the couple conflict discussion was associated with maternal self-report of better overall child health (p = 0.016, 95% CI = [0.06, 1.30], Cohen’s f = 0.045) across the study period. Greater cortisol reactivity was also associated with lower incidence rate ratios (IRRs) for maternal reports of sick doctor visits (IRR 95% CI = [0.25, 0.83], p = 0.006), fevers (CI = [0.25, 0.73], p = 0.002), ear infections (CI = [0.25, 0.58], p < 0.001), and respiratory infections (CI = [0.08, 1.11], p = 0.073). Cortisol recovery was unrelated to study outcomes (all ps > 0.05). Maternal prenatal depressive symptoms moderated the association between cortisol reactivity and overall child health (p = 0.034, 95% CI = [0.07, 1.87] for interaction term) but no other health outcomes (ps > 0.05). Among women with lower depressive symptoms, cortisol reactivity was not associated with overall child health; among women with higher levels of depressive symptoms, greater cortisol reactivity was associated with better overall child health.

CONCLUSIONS: This study provides longitudinal evidence that greater maternal cortisol reactivity to a salient interpersonal stressor during pregnancy is associated with fewer child health problems and better maternal report of overall child health during infancy and into early childhood.

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Keywords: Cortisol, reactivity, stress, infancy, mothers, mother-infant relationships