Abstract
BackgroundChildren from socioeconomically disadvantaged families have a markedly elevated risk for impaired cognitive and social-emotional development. Children in poverty experience have a high risk for developmental delays. Poverty engenders disproportionate exposure to psychological adversity which may contribute to impaired offspring development; however the effect may be mitigated by social support and other aspects of resilience. Our objective was to determine the association between maternal stress, adversity and social support and early infant neurobehavior and child behavior at two and three years.MethodsWe conducted a longitudinal mother-infant cohort study nested within a regional home visiting program in Cincinnati, Ohio. Four home study visits were completed to collect measures of maternal stress, adversity and social support and infant and child behavior. A measure of infant neurobehavior (‘high-arousal’ infant) was derived from the NICU Network Neurobehavioral Scale (NNNS) at 1 month and externalizing and internalizing symptoms were measured by the Child Behavior Checklist (CBCL) at 24 and 36 months. Linear and logistic regression identified associations between maternal risk/protective factors and infant and child behavioral measures. We used stratification and multiplicative interaction terms to examine potential interactions.ResultsWe enrolled n = 55 pregnant mothers and follow 53 mother–offspring dyads at 1 month, 40 dyads at 24 months and 27 dyads at 36 months. Maternal adversity and protective factors were not associated with neurobehavior at one month. However, maternal depression and measures of distress in pregnancy were significantly associated with internalizing and externalizing symptoms at 24 and 36 months.ConclusionsThis pilot study established the feasibility of conducting longitudinal research within a community intervention program. In addition, although there were no statistically significant associations between maternal psychosocial factors in pregnancy and infant neurobehavior, there were several associations at 24 months, primarily internalizing symptoms, which persisted through 36 months. Future work will replicate findings within a larger study as well as explore mediators and modifiers of these associations.
Highlights
Children from socioeconomically disadvantaged families have a markedly elevated risk for impaired cognitive and social-emotional development
The overall goal of our research is to reduce developmental health disparities by optimizing home visiting practices which serve at-risk families
We recruited from a limited sample of 8 home-visiting agencies in Hamilton County
Summary
Children from socioeconomically disadvantaged families have a markedly elevated risk for impaired cognitive and social-emotional development. Children in poverty experience have a high risk for developmental delays. Poverty engenders disproportionate exposure to psychological adversity which may contribute to impaired offspring development; the effect may be mitigated by social support and other aspects of resilience. Poverty carries disproportionate risks for childhood developmental delays [3], impaired language and literacy [4], and negative social-emotional function [5, 6]. A broad literature has identified an association between maternal psychological stress and adversity and developmental outcomes. This association may explain the disproportion of poor developmental outcomes among families with high sociodemographic risk [7, 8]. Despite a growing body of literature, the types and timing of stressors, modifiers of the association, and the underlying biologic mechanisms remain uncertain
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