Associations among maternal lifetime trauma, psychiatric symptoms in pregnancy, and infant stress reactivity and regulation

Sophie Foss, PhD

Boston Children’s Hospital
Associations among maternal lifetime trauma, psychiatric symptoms in pregnancy, and infant stress reactivity and regulation

Scientific Abstract

Background: Maternal adversity has been linked to worse birth outcomes, altered newborn brain morphology, and poorer child mental health. Research is more limited regarding effects of maternal adversity on infant reactivity to and regulation of stress, which have been associated with neurobehavioral challenges in childhood. Indirect evidence suggests that maternal mental health, a documented sequela of trauma exposure and predictor of altered self-regulatory capacity in offspring, may contribute to associations between maternal adversity and poor infant outcomes. This study assessed associations among maternal lifetime trauma, psychiatric symptoms in pregnancy, and infant reactivity and regulation.

Methods: N=677 mothers were recruited in pregnancy. They completed the Life Stressor Checklist-Revised, Edinburgh Postnatal Depression Scale, and Spielberger State-Trait Anxiety Inventory. When infants were 6 months old, mothers completed the Infant Behavior Questionnaire-Revised, which provided measures of infant reactivity and regulation. Hypotheses were tested with mediation models in PROCESS.

Results: Greater maternal lifetime trauma exposure and depressive and anxiety symptoms in pregnancy were associated with increased reactivity and poorer regulation in infants (p<.01). Maternal depressive (IE=.04) and anxiety (IE=.03) symptoms mediated the association between maternal trauma history and infant reactivity. Maternal anxiety symptoms mediated the association between maternal trauma history and infant regulation (IE=-.05).

Conclusions: Maternal trauma exposure and anxiety/depressive symptoms in pregnancy were associated with increased infant stress reactivity and poorer regulation. Maternal anxiety/depressive symptoms mediated links between maternal trauma and infant reactivity/regulation. Results highlight potential contributory mechanisms to maladaptive infant reactivity and regulation, which have been associated with higher risk of behavior problems, ADHD, and poor academic outcomes. Findings may result in earlier identification of at-risk children, allowing for earlier implementation of interventions.

research Areas

Authors

Sophie C. Foss, PhD, Deborah P. Waber, PhD, Rosalind J. Wright, MD, MPH, Michelle Bosquet Enlow, PhD