Hostname: page-component-5d59c44645-jb2ch Total loading time: 0 Render date: 2024-02-21T08:36:29.930Z Has data issue: false hasContentIssue false

Prenatal stress and risk of behavioral morbidity from age 2 to 14 years: The influence of the number, type, and timing of stressful life events

Published online by Cambridge University Press:  18 April 2011

Monique Robinson*
Affiliation:
University of Western Australia
Eugen Mattes
Affiliation:
University of Western Australia
Wendy H. Oddy
Affiliation:
University of Western Australia
Craig E. Pennell
Affiliation:
University of Western Australia
Anke van Eekelen
Affiliation:
University of Western Australia
Neil J. McLean
Affiliation:
University of Western Australia
Peter Jacoby
Affiliation:
University of Western Australia
Jianghong Li
Affiliation:
Curtin University
Nicholas H. De Klerk
Affiliation:
University of Western Australia
Stephen R. Zubrick
Affiliation:
Curtin University
Fiona J. Stanley
Affiliation:
University of Western Australia
John P. Newnham
Affiliation:
Curtin University
*
Address correspondence and reprint requests to: Monique Robinson, Telethon Institute for Child Health Research, Center for Child Health Research, University of Western Australia, P.O. Box 855, West Perth, WA 6872, Australia; E-mail: moniquer@ichr.uwa.edu.au.

Abstract

The maternal experience of stressful events during pregnancy has been associated with a number of adverse consequences for behavioral development in offspring, but the measurement and interpretation of prenatal stress varies among reported studies. The Raine Study recruited 2900 pregnancies and recorded life stress events experienced by 18 and 34 weeks' gestation along with numerous sociodemographic data. The mother's exposure to life stress events was further documented when the children were followed-up in conjunction with behavioral assessments at ages 2, 5, 8, 10, and 14 years using the Child Behavior Checklist. The maternal experience of multiple stressful events during pregnancy was associated with subsequent behavioral problems for offspring. Independent (e.g., death of a relative, job loss) and dependent stress events (e.g., financial problems, marital problems) were both significantly associated with a greater incidence of mental health morbidity between age 2 and 14 years. Exposure to stressful events in the first 18 weeks of pregnancy showed similar associations with subsequent total and externalizing morbidity to events reported at 34 weeks of gestation. These results were independent of postnatal stress exposure. Improved support for women with chronic stress exposure during pregnancy may improve the mental health of their offspring in later life.

Type
Regular Articles
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4–18 and 1991 profile. Burlington, VT: University of Vermont, Department of Psychiatry.Google Scholar
Achenbach, T. M., Edelbrock, C., & Howell, C. T. (1987). Empirically based assessment of the behavioural/emotional problems of 2- and 3-year-old children. Journal of Abnormal Child Psychology, 15, 629650.Google Scholar
Austin, M.-P., Hadzi-Pavlovic, D., Leader, L., Saint, K., & Parker, G. (2005). Maternal trait anxiety, depression and life event stress in pregnancy: Relationships with infant temperament. Early Human Development, 81, 183190.Google Scholar
Austin, M.-P., Leader, L., & Reilly, N. (2005). Prenatal stress, the hypothalamic–pituitary–adrenal axis, and fetal and infant neurobehaviour. Early Human Development, 81, 917926.Google Scholar
Baum, A., Garofalo, J. P., & Yali, A. M. (1999). Socioeconomic status and chronic stress: Does stress account for SES effects on health? Annals of the New York Academy of Sciences, 896, 131144.Google Scholar
Bérubé, R. L., & Achenbach, T. M. (2007). Bibliography of published studies using the ASEBA. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.Google Scholar
Brugha, T. S., & Cragg, D. (1990). The List of Threatening Experiences: The reliability and validity of a brief life events questionnaire. Acta Psychiatrica Scandinavica, 82, 7781.Google Scholar
Carmichael, S. L., Shaw, G. M., Yang, W., Abrams, B., & Lammer, E. J. (2007). Maternal stressful life events and risks of birth defects. Epidemiology, 18, 356361.Google Scholar
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385396.Google Scholar
Cowan, P. A., & Cowan, C. P. (2002). Interventions as tests of family systems theories: Marital and family relationships in children's development and psychopathology. Development and Psychopathology, 14, 731759.Google Scholar
DiPietro, J. A. (2004). The role of prenatal maternal stress in child development. Current Directions in Psychological Science, 13, 7174.Google Scholar
Dohrenwend, B. S., & Dohrenwend, B. P. (1978). Some issues in research on stressful life events. Journal of Nervous and Mental Disease, 166, 715.Google Scholar
Dole, N., Savitz, D. A., Hertz-Picciotto, I., Siega-Riz, A. M., McMahon, M. J., & Buekens, P. (2003). Maternal stress and preterm birth. American Journal of Epidemiology, 157, 1424.Google Scholar
Entringer, S., Wust, S., Kumsta, R., Layes, I. M., Nelson, E. L., Hellhammer, D. H., et al. (2008). Prenatal psychosocial stress exposure is associated with insulin resistance in young adults. American Journal of Obstetrics and Gynecology, 199, 498.e1–498.e7.Google Scholar
Field, T., & Diego, M. (2008). Cortisol: The culprit prenatal stress variable. International Journal of Neuroscience, 118, 11811205.Google Scholar
French, N. P., Hagan, R., Evans, S. F., Mullan, A., & Newnham, J. P. (2004). Repeated antenatal corticosteroids: Effects on cerebral palsy and childhood behavior. American Journal of Obstetrics and Gynecology, 190, 588595.Google Scholar
Geller, P. A. (2004). Pregnancy as a stressful life event. CNS Spectrums, 9, 188197.Google Scholar
Glynn, L. M., Dunkel-Schetter, C., Wadhwa, P. D., & Sandman, C. A. (2004). Pregnancy affects appraisal of negative life events. Journal of Psychosomatic Research, 56, 4752.Google Scholar
Glynn, L. M., Wadhwa, P. D., Dunkel-Schetter, C., Chicz-Demet, A., & Sandman, C. A. (2001). When stress happens matters: effects of earthquake timing on stress responsivity in pregnancy. American Journal of Obstetrics and Gynecology, 184, 637642.Google Scholar
Gravelle, H. (1998). How much of the relation between population mortality and unequal distribution of income is a statistical artefact? British Medical Journal, 316, 382385.Google Scholar
Hammen, C. (1991). Generation of stress in the course of unipolar depression. Journal of Abnormal Psychology, 100, 555561.Google Scholar
Hedegaard, M., Henriksen, T. B., Sabroe, S., & Secher, N. J. (1993). Psychological distress in pregnancy and preterm delivery. British Medical Journal, 307, 234239.Google Scholar
Holmes, T. H., & Rahe, R. H. (1967). The Social Readjustment Rating Scale. Journal of Psychosomatic Research, 11, 213218.Google Scholar
Hook, B., Hagglof, B., & Thernlund, G. (1995). Life events and behavioural deviances in childhood: A longitudinal study of a normal population. European Child and Adolescent Psychiatry, 4, 153164.Google Scholar
Huizink, A. C., Robles de Medina, P. G., Mulder, E. J. H., Visser, G. H. A., & Buitelaar, J. K. (2003). Stress during pregnancy is associated with developmental outcome in infancy. Journal of Child Psychology and Psychiatry, 44, 810818.Google Scholar
Kammerer, M., Taylor, A., & Glover, V. (2006). The HPA axis and perinatal depression: A hypothesis. Archives of Women's Mental Health, 9, 187196.Google Scholar
Kofman, O. (2002). The role of prenatal stress in the etiology of developmental behavioural disorders. Neuroscience & Biobehavioral Reviews, 26, 457470.Google Scholar
Laplante, D. P., Barr, R. G., Brunet, A., Galbaud du Fort, G., Meaney, M. L., Saucier, J. F., et al. (2004). Stress during pregnancy affects general intellectual and language functioning in human toddlers. Pediatric Research, 56, 400410.Google Scholar
Leonhardt, M., Matthews, S. G., Meaney, M. J., & Walker, C. D. (2007). Psychological stressors as a model of maternal adversity: Diurnal modulation of corticosterone responses and changes in maternal behavior. Hormones and Behavior, 51, 7788.Google Scholar
Li, J., Kendall, G. E., Henderson, S., Downie, J., Landsborough, L., & Oddy, W. H. (2008). Maternal psychosocial wellbeing in pregnancy and breastfeeding duration. Acta Paediatrica, 97, 221225.Google Scholar
Lobel, M. (1994). Conceptualizations, measurement, and effects of prenatal maternal stress on birth outcomes. Journal of Behavioral Medicine, 17, 225272.Google Scholar
Malaspina, D., Corcoran, C., Kleinhaus, K. R., Perrin, M. C., Fennig, S., Nahon, D., et al. (2008). Acute maternal stress in pregnancy and schizophrenia in offspring: A cohort prospective study. BMC Psychiatry, 8, 71.Google Scholar
Mastorakos, G., & Ilias, I. (2000). Maternal hypothalamic–pituitary–adrenal axis in pregnancy and the postpartum period. Postpartum-related disorders. Annals of the New York Academy of Sciences, 900, 95106.Google Scholar
Monroe, S. M., & Reid, M. W. (2008). Gene–environment interactions in depression research: Genetic polymorphisms and life-stress polyprocedures. Psychological Science, 19, 947956.Google Scholar
Newnham, J. P., Evans, S. F., Michael, C. A., Stanley, F. J., & Landau, L. I. (1993). Effects of frequent ultrasound during pregnancy: A randomised controlled trial. Lancet, 342, 887891.Google Scholar
Newnham, J. P., Moss, T. J., Nitsos, I., Sloboda, D. M., & Challis, J. R. G. (2002). Nutrition and the early origins of adult disease. Asia Pacific Journal of Clinical Nutrition, 11 (Suppl. 3), S537S542.Google Scholar
O'Connor, T. G., Heron, J., Golding, J., Beveridge, M., & Glover, V. (2002). Maternal antenatal anxiety and children's behavioural/emotional problems at 4 years: Report from the Avon Longitudinal Study of Parents and Children. British Journal of Psychiatry, 180, 502508.Google Scholar
Paarlberg, K. M., Vingerhoets, A. J., Passchier, J., Dekker, G. A., Heinen, A. G., & van Geijn, H. P. (1999). Psychosocial predictors of low birthweight: A prospective study. British Journal of Obstetrics and Gynaecology, 106, 834841.Google Scholar
Paarlberg, K. M., Vingerhoets, A. J., Passchier, J., Dekker, G. A., & Van Geijn, H. P. (1995). Psychosocial factors and pregnancy outcome: A review with emphasis on methodological issues. Journal of Psychosomatic Research, 39, 563595.Google Scholar
Robertson, E., Grace, S., Wallington, T., & Stewart, D. E. (2004). Antenatal risk factors for postpartum depression: A synthesis of recent literature. General Hospital Psychiatry, 26, 289295.Google Scholar
Robinson, M., Oddy, W. H., Li, J., Kendall, G. E., de Klerk, N. H., Silburn, S. R., et al. (2008). Pre- and postnatal influences on preschool mental health: A large-scale cohort study. Journal of Child Psychology and Psychiatry, 49, 11181128.Google Scholar
Robinson, M., Oddy, W. H., McLean, N. J., Jacoby, P., Pennell, C. E., de Klerk, N. H., et al. (2010). Low-moderate prenatal alcohol exposure and risk to child behavioural development: A prospective cohort study. British Journal of Obstetrics and Gynaecology, 117, 11391152.Google Scholar
Rodriguez, A., & Bohlin, G. (2005). Are maternal smoking and stress during pregnancy related to ADHD symptoms in children? Journal of Child Psychology and Psychiatry, 46, 246254.Google Scholar
Rondo, P. H., Ferreira, R. F., Nogueira, F., Ribeiro, M. C., Lobert, H., & Artes, R. (2003). Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation. European Journal of Clinical Nutrition, 57, 266272.Google Scholar
Rudolph, K. D., & Hammen, C. (1999). Age and gender as determinants of stress exposure, generation, and reactions in youngsters: A transactional perspective. Child Development, 70, 660677.Google Scholar
Safford, S. M., Alloy, L. B., Abramson, L. Y., & Crossfield, A. G. (2007). Negative cognitive style as a predictor of negative life events in depression-prone individuals: A test of the stress generation hypothesis. Journal of Affective Disorders, 99, 147154.Google Scholar
Saunders, T. A., Lobel, M., Veloso, C., & Meyer, B. A. (2006). Prenatal maternal stress is associated with delivery analgesia and unplanned cesareans. Journal of Psychosomatic Obstetrics & Gynecology, 27, 141146.Google Scholar
Schneider, M. L., Roughton, E. C., Koehler, A. J., & Lubach, G. R. (1999). Growth and development following prenatal stress exposure in primates: An examination of ontogenetic vulnerability. Child Development, 70, 263274.Google Scholar
Seckl, J. R., & Holmes, M. C. (2007). Mechanisms of disease: Glucocorticoids, their placental metabolism and fetal “programming” of adult pathophysiology. Nature Clinical Practice Endocrinology and Metabolism, 3, 479488.Google Scholar
Seguin, L., Potvin, L., St-Denis, M., & Loiselle, J. (1995). Chronic stressors, social support, and depression during pregnancy. Obstetrics and Gynecology, 85, 583589.Google Scholar
Sloboda, D. M., Challis, J. R., Moss, T. J., & Newnham, J. P. (2005). Synthetic glucocorticoids: Antenatal administration and long-term implications. Current Pharmaceutical Design, 11, 14591472.Google Scholar
Spauwen, J., Krabbendam, L., Lieb, R., Wittchen, H. U., & van Os, J. (2004). Early maternal stress and health behaviours and offspring expression of psychosis in adolescence. Acta Psychiatrica Scandinavica, 110, 356364.Google Scholar
Talge, N. M., Neal, C., & Glover, V. (2007). Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? Journal of Child Psychology and Psychiatry, 48, 245261.Google Scholar
Tennant, C., & Andrews, G. (1976). A scale to measure the stress of life events. Australian and New Zealand Journal of Psychiatry, 10, 2732.Google Scholar
Urizar, G. G. Jr., Milazzo, M., Le, H. N., Delucchi, K., Sotelo, R., & Munoz, R. F. (2004). Impact of stress reduction instructions on stress and cortisol levels during pregnancy. Biological Psychology, 67, 275282.Google Scholar
Van den Bergh, B. R., Mulder, E. J., Mennes, M., & Glover, V. (2005). Antenatal maternal anxiety and stress and the neurobehavioural development of the fetus and child: Links and possible mechanisms. A review. Neuroscience & Biobehavioral Reviews, 29, 237258.Google Scholar
Villar, J., Farnot, U., Barros, F., Victora, C., Langer, A., & Belizan, J. M. (1992). A randomized trial of psychosocial support during high-risk pregnancies. The Latin American Network for Perinatal and Reproductive Research. New England Journal of Medicine, 327, 12661271.Google Scholar
Wadhwa, P. D., Culhane, J. F., Rauh, V., Barve, S. S., Hogan, V., Sandman, C. A., et al. (2001). Stress, infection and preterm birth: A biobehavioural perspective. Paediatric and Perinatal Epidemiology, 15(Suppl. 2), 1729.Google Scholar
Wadhwa, P. D., Dunkel-Schetter, C., Chicz-DeMet, A., Porto, M., & Sandman, C. A. (1996). Prenatal psychosocial factors and the neuroendocrine axis in human pregnancy. Psychosomatic Medicine, 58, 432446.Google Scholar
Wadhwa, P. D., Sandman, C. A., Porto, M., Dunkel-Schetter, C., & Garite, T. J. (1993). The association between prenatal stress and infant birth weight and gestational age at birth: A prospective investigation. American Journal of Obstetrics and Gynecology, 169, 858865.Google Scholar
Warnick, E. M., Bracken, M. B., & Kasl, S. (2008). Screening efficiency of the Child Behavior Checklist and Strengths and Difficulties Questionnaire: A systematic review. Child and Adolescent Mental Health, 13, 140147.Google Scholar
Wethington, E., Brown, G. W., & Kessler, R. C. (1995). Interview measurement of stressful life events. New York: Oxford University Press.Google Scholar
Wolfson, M., Kaplan, G., Lynch, J., Ross, N., & Backlund, E. (1999). Relation between income inequality and mortality: Empirical demonstration. British Medical Journal, 319, 953955.Google Scholar
Zubrick, S., Silburn, S., Gurrin, L., Teoh, H., Shepherd, C., Carlton, J., et al. (1997). Western Australian Child Health Survey: Education, health and competence. Perth, Australia: Australian Bureau of Statistics and the Telethon Institute for Child Health Research.Google Scholar