(PS12-32) Maternal Prenatal Stress and Child Mental Health: Testing the Moderating Effects of Maternal Stress in Infancy and Toddlerhood

Emerging research suggests that there are sensitive windows of development when caregiver stress is an especially potent risk factor for children developing internalizing and externalizing problems. One sensitive window is the prenatal period, as it is a time of rapid biological (e.g., neuroendocrine) and social (e.g., new parenting roles) change for both the mother and child. Despite evidence highlighting that prenatal stress is uniquely predictive of later child mental health problems, less is known about how varying levels of stress throughout mothers’ post-natal stages may moderate links between prenatal stress and child mental health problems. Such knowledge may shed light on prenatally stressed mothers whose children are more or less at risk of increased mental health symptoms. The present study aims to examine whether the link between maternal prenatal stress and later child internalizing and externalizing symptoms differs by their levels of stress in the infancy and toddler stages.

The present study utilized data from the Environment Influences on Child Health Outcomes (ECHO) dataset. Included participants had valid data in all three time points (prenatal, infancy, toddler; N = 450). Mothers reported their perceived levels of stress during prenatal, infancy (birth – 2 years) and toddler (age 3 – 5 years) time points. Mothers also provided ratings of their child’s internalizing and externalizing symptoms at age 5.

 Linear regressions examined maternal prenatal stress x infancy/toddler stress interactions as predictors of later child internalizing and externalizing symptoms. Findings revealed one significant (maternal prenatal stress x infancy stress) interaction predicting child externalizing symptoms (R² =.103). Mothers who reported high (+1SD) prenatal stress and high (+1SD) infancy stress rated their children as having more externalizing symptoms than mothers reporting average (mean) or low (-1SD) infancy stress, regardless of their prenatal stress. The maternal prenatal stress x toddler stress interaction did not predict externalizing symptoms, though both main effects uniquely predicted more child externalizing symptoms (R² =.110). Maternal prenatal x infancy/toddler stress interactions did not predict internalizing symptoms, with only maternal stress during toddler stage being a unique predictor child internalizing symptoms (R² =.059).

The present study expands upon existing literature by demonstrating that the link between maternal prenatal stress and child mental health problems largely does not vary depending on levels of postnatal stress. However, one exception was mothers reporting mutual above-average levels of prenatal and infancy stress also reported their children having greater externalizing symptoms. Otherwise, maternal stress at prenatal and toddler stages uniquely predicted elevated child externalizing symptoms. The present findings inform future studies seeking to understand the timing effects of stress towards development of child externalizing, but not internalizing, symptoms. If replicated, future research should seek to investigate mechanisms (e.g., parenting skills) that may account for prospective links between maternal stress and child externalizing symptoms.