Elsevier

Biological Psychiatry

Volume 58, Issue 3, 1 August 2005, Pages 211-217
Biological Psychiatry

Original article
Prenatal Anxiety Predicts Individual Differences in Cortisol in Pre-Adolescent Children

https://doi.org/10.1016/j.biopsych.2005.03.032Get rights and content

Background

Animal studies suggest that prenatal stress is associated with long-term disturbance in hypothalamic-pituitary-adrenal (HPA) axis function, but evidence in humans is lacking. This study examined the long-term association between prenatal anxiety and measures of diurnal cortisol at age 10 years.

Methods

Measures of cortisol were collected at awakening, 30 min after awakening, and at 4 pm and 9 pm on 3 consecutive days in a sample of 10-year-olds (n = 74) from the Avon Longitudinal Study of Parents and Children, a prospective longitudinal cohort study of mothers and children on whom measures of anxiety and depression were collected in pregnancy and the postpartum period. Analyses examined the links between symptoms of prenatal anxiety and multiple indicators of cortisol, an index of HPA axis functioning.

Results

Prenatal anxiety was significantly associated with individual differences in awakening and afternoon cortisol after accounting for obstetric and sociodemographic risk (partial correlations were .32 and .25, p < .05). The effect for awakening cortisol remained significant after controlling for multiple postnatal assessments of maternal anxiety and depression.

Conclusions

This study provides the first human evidence that prenatal anxiety might have lasting effects on HPA axis functioning in the child and that prenatal anxiety might constitute a mechanism for an increased vulnerability to psychopathology in children and adolescents.

Section snippets

Subjects

The ALSPAC is a prospective study of women, their partners, and an index child. The 14,541 enrolled pregnancies (from April 1, 1991 to December 31, 1992) represented 85%–90% of the eligible population resident in three health authorities around Bristol, United Kingdom (Golding et al 2001). Of these, 14,138 surviving children (13,995 mothers) are being followed. The average age of the women at pregnancy was 28 years and ranged from 14 to 46 years; less than 5% were younger than 20 years, and

Results

Preliminary analyses indicated that there was the usual and substantial diurnal variation in cortisol levels for each of the 3 days assessed, with close correspondence among diurnal curves for the 3 days (Figure 1). There was not a significant increase in cortisol from awakening to 30 min after awakening in the group as a whole [means (SD): 10.4 (3.2) and 10.2 (4.1), respectively; paired t test, t(69) =.38]. Stability of individual differences in cortisol values across the 3 days was moderate.

Discussion

We found that anxiety in late pregnancy was associated with individual differences in measures of cortisol in pre-adolescents. The link between prenatal anxiety and offspring HPA axis function was strongest at 32 weeks’ gestation and especially robust for awakening cortisol. These results provide the strongest evidence to date that prenatal stress is associated with longer-term impact on the HPA axis of the human offspring, a finding repeatedly demonstrated in animal investigations.

There was

References (52)

  • R. Ader et al.

    Prenatal maternal anxiety and offspring emotionality in the rat

    Psychol Rep

    (1963)
  • D.J. Barker

    The fetal origins of adult disease

    Proc R Soc Lond B Biol Sci

    (1995)
  • Y. Ben-Shlomo et al.

    A life course approach to chronic disease epidemiologyConceptual models, empirical challenges and interdisciplinary perspectives

    Int J Epidemiol

    (2002)
  • J. Birtchnell et al.

    The total score of the Crown-Crisp Experiential IndexA useful and valid measure of psychoneurotic pathology

    Br J Med Psychol

    (1988)
  • E.P.M. Brouwers et al.

    Maternal anxiety during pregnancy and subsequent infant development

    Infant Behav Dev

    (2001)
  • J.R. Challis et al.

    Current topicThe placental corticotrophin-releasing hormone-adrenocorticotrophin axis

    Placenta

    (1995)
  • D. Cicchetti et al.

    Stress and developmentBiological and psychological consequences

    Dev Psychopathol

    (2001)
  • A. Clow et al.

    The awakening cortisol responseMethodological issues and significance

    Stress

    (2004)
  • C.L. Coe et al.

    Prenatal stress diminishes neurogenesis in the dentate gyrus of juvenile rhesus monkeys

    Biol Psychiatry

    (2003)
  • C.L. Coe et al.

    Prenatal stress diminishes the cytokine response of leukocytes to endotoxin stimulation in juvenile rhesus monkeys

    J Clin Endocrinol Metab

    (2002)
  • J.L. Cox et al.

    Detection of postnatal depressionDevelopment of the 10 item Edinburgh Postnatal Depression Scale

    Br J Psychiatry

    (1987)
  • J.A. DiPietro et al.

    Fetal response to induced maternal stress

    Early Hum Dev

    (2003)
  • M.A. Ellenbogen et al.

    High levels of cortisol among adolescent offspring of parents with bipolar disorderA pilot study

    Psychoneuroendocrinology

    (2004)
  • M.J. Essex et al.

    Maternal stress beginning in infancy may sensitize children to later stress exposureEffects on cortisol and behavior

    Biol Psychiatry

    (2002)
  • A. Feder et al.

    Twenty-four-hour cortisol secretion patterns in prepubertal children with anxiety of depressive disorders

    Biol Psychiatry

    (2004)
  • R. Gitau et al.

    Fetal HPA stress responses to invasive procedures are independent of maternal responses

    J Clin Endocrinol Metab

    (2001)
  • V. Glover et al.

    Antenatal maternal anxiety is linked with atypical handedness in the child

    Early Hum Dev

    (2004)
  • R.S. Goland et al.

    Placental corticotropin-releasing hormone and the hypercortisolism of pregnancy

    Am J Obstet Gynecol

    (1994)
  • S. Goldberg et al.

    Cortisol concentrations in 12- to 18-month-old infantsStability over time, location, and stressor

    Biol Psychiatry

    (2003)
  • J. Golding et al.

    ALSPAC—The Avon Longitudinal Study of Parents and Children. I. Study methodology

    Paediatr Perinat Epidemiol

    (2001)
  • I.M. Goodyer et al.

    Adrenal secretion during major depression in 8- to 16-year-olds, I. Altered diurnal rhythms in salivary cortisol and dehydroepiandrosterone (DHEA) at presentation

    Psychol Med

    (1996)
  • I.M. Goodyer et al.

    Recent life events, cortisol, dehydroepiandrosterone and the onset of major depression in high risk adolescents

    Br J Psychiatry

    (2000)
  • M.R. Gunnar et al.

    Low cortisol and a flattening of expected daytime rhythmPotential indices of risk in human development

    Dev Psychopathol

    (2001)
  • S.L. Halligan et al.

    Exposure to postnatal depression predicts elevated cortisol in adolescent offspring

    Biol Psychiatry

    (2004)
  • T.O. Harris et al.

    Morning cortisol as a risk factor for subsequent major depressive disorder in adult women

    Br J Psychiatry

    (2000)
  • C. Heim et al.

    Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood

    JAMA

    (2000)
  • Cited by (0)

    View full text