Prenatal maternal stress, HPA axis activity, and postnatal infant development

Abstract

Objective: We examined whether psychological and endocrinological measures of stress during pregnancy predicted developmental outcome of human infants in a prospective design. Methods: Self-report data about daily hassles, pregnancy-specific anxiety and perceived stress, salivary cortisol levels and adrenocorticotropic hormone (ACTH) levels were collected in nulliparous women throughout pregnancy. Infant development was measured at 3 and 8 months by means of the Bayley Scales of Infant Development (BSID). Infant temperament was rated by means of observed behavior and maternal report. Results: High levels of pregnancy-specific anxiety in early pregnancy predicted both temperamental and developmental difficulties. High amounts of daily hassles in early pregnancy were associated with lower mental developmental scores. Perceived stress in early pregnancy was related to more difficult behavior and adaptational problems. Early morning values of cortisol in late pregnancy were negatively related to both mental and motor development, whereas higher ACTH levels were related to more adaptational problems. All results were adjusted for a large number of covariates. Conclusion: Increased maternal prenatal stress seems to be one of the determinants of temperamental and developmental variation of infants. The hypothalamic–pituitary–adrenal (HPA) axis may be involved in the harmful effects of prenatal maternal stress on infant development and temperament.