Elsevier

Biological Psychiatry

Volume 67, Issue 11, 1 June 2010, Pages 1026-1032
Biological Psychiatry

Archival Report
Maternal Prenatal Cortisol and Infant Cognitive Development: Moderation by Infant–Mother Attachment

https://doi.org/10.1016/j.biopsych.2010.01.002Get rights and content

Background

Experimental animal studies suggest that early glucocorticoid exposure may have lasting effects on the neurodevelopment of the offspring; animal studies also suggest that this effect may be eliminated by positive postnatal rearing. The relevance of these findings to humans is not known.

Methods

We prospectively followed 125 mothers and their normally developing children from pregnancy through 17 months postnatal. Amniotic fluid was obtained at, on average, 17.2 weeks gestation; infants were assessed at an average age of 17 months with the Bayley Scales of Infant Development, and ratings of infant–mother attachment classification were made from the standard Ainsworth Strange Situation assessment.

Results

Prenatal cortisol exposure, indexed by amniotic fluid levels, negatively predicted cognitive ability in the infant, independent of prenatal, obstetric, and socioeconomic factors. This association was moderated by child–mother attachment: in children with an insecure attachment, the correlation was [r(54) = −.47, p < .001]; in contrast, the association was nonexistent in children who had a secure attachment [r(70) = −.05, ns].

Conclusions

These findings mimic experimental animal findings and provide the first direct human evidence that increased cortisol in utero is associated with impaired cognitive development, and that its impact is dependent on the quality of the mother–infant relationship.

Section snippets

Participants

Mothers and babies were recruited as part of a prospective study on fetal hormone exposure and child development (30). Women were recruited sequentially from an amniocentesis clinic for karyotyping in a large urban maternity hospital between December 2001 and January 2005. Written informed consent was obtained from mothers; the study was approved by the institutional Research Ethics Committee at Imperial College London.

Of the 365 women who were recruited at amniocentesis, 109 were excluded

Results

Demographic data show that, as might be expected from a sample undergoing karyotyping, the sample included a sizable set of older pregnant women but ranged widely; there is also a comparatively high representation of individuals with a university degree. Both maternal age and education are included as covariates. In several other key areas, the sample was diverse and within normal range in terms of sociodemographic indicators, attachment classification, and child cognitive developmental scaled

Discussion

A sizable literature of experimental animal work on the programming effects of prenatal stress on the offspring is now being translated to human development. Among the findings so far reported, the association between prenatal anxiety or stress and child cognitive development is one of the most reliable and widely reported (6, 41). An underlying hypothesis, based on experimental animal work, is that the effect of prenatal stress or anxiety on infant outcomes such as cognitive development

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