Maternal stress during pregnancy alters fetal cortico-cerebellar connectivity in utero and increases child sleep problems after birth

Marion I Van Den Heuvel,Jasmine L Hect,Jeanne Barcelona,Tamara Qawasmeh,Benjamin L Smarr,Moriah E Thomason,Kowsar E Hijazi,Lance J Kriegsfeld

doi:10.1038/s41598-021-81681-y

Abstract

Child sleep disorders are increasingly prevalent and understanding early predictors of sleep problems, starting in utero, may meaningfully guide future prevention efforts. Here, we investigated whether prenatal exposure to maternal psychological stress is associated with increased sleep problems in toddlers. We also examined whether fetal brain connectivity has direct or indirect influence on this putative association. Pregnant women underwent fetal resting-state functional connectivity MRI and completed questionnaires on stress, worry, and negative affect. At 3-year follow-up, 64 mothers reported on child sleep problems, and in the subset that have reached 5-year follow-up, actigraphy data (N = 25) has also been obtained. We observe that higher maternal prenatal stress is associated with increased toddler sleep concerns, with actigraphy sleep metrics, and with decreased fetal cerebellar-insular connectivity. Specific mediating effects were not identified for the fetal brain regions examined. The search for underlying mechanisms of the link between maternal prenatal stress and child sleep problems should be continued and extended to other brain areas.

Highlights

Child sleep disorders are increasingly prevalent and understanding early predictors of sleep problems, starting in utero, may meaningfully guide future prevention efforts
Follow-up correlations with individual stress/negative affect scales indicated that the strongest association were found for maternal perceived stress (PSST: r = 0.279, p = 0.028) and worry (PSWQ: r = 0.348, p = 0.007) during pregnancy, while no association was found for maternal prenatal depression, life satisfaction and anxiety during pregnancy and child sleep
This study presents investigation of the role of fetal cortico-cerebellar functional connectivity (FC) in the association between maternal prenatal negative affect and stress and toddler sleep problems

Summary

Introduction

Child sleep disorders are increasingly prevalent and understanding early predictors of sleep problems, starting in utero, may meaningfully guide future prevention efforts. We investigated whether prenatal exposure to maternal psychological stress is associated with increased sleep problems in toddlers. We observe that higher maternal prenatal stress is associated with increased toddler sleep concerns, with actigraphy sleep metrics, and with decreased fetal cerebellar-insular connectivity. Longitudinal data suggest that sleep disturbance in early childhood is associated with negative adolescent health outcomes, such as increased risk for obesity especially among minority participants of low S ES6. Given that child hypervigilance and hyper-arousal are associated with prenatal stress e xposure[9,10,11,12], it follows that prenatal exposure to maternal stress and negative affect may be a risk factor for the development of early sleep problems. Despite growing evidence of a relationship between the prenatal environment and sleep problems, no study to date has explored neural mechanisms by which maternal stress may affect child sleep patterns before birth

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