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Associations between maternal prenatal cortisol concentrations and child outcomes: A systematic review
Maartje A C Zijlmans1, J Marianne Riksen-Walraven1, Carolina de Weerth1
1Department of Developmental Psychology, Behavioural Science Institute, Radboud University Nijmegen, Postbus 9104, 6500 HE Nijmegen, The Netherlands.
Insights
Maternal prenatal cortisol levels show a small but significant association with altered child development, including health, cognitive, and behavioral outcomes. However, cortisol may not be the sole mechanism linking prenatal stress to child outcomes.
Area of Science:
- Developmental Psychology
- Neuroendocrinology
- Maternal-Child Health
Background:
- Maternal prenatal stress and anxiety are linked to adverse child outcomes.
- Heightened maternal cortisol concentrations are a proposed mechanism for this link.
Purpose of the Study:
- To systematically review empirical findings on maternal prenatal cortisol concentrations and child outcomes.
- To summarize associations across physical/health, cognitive/motor, psychological/behavioral, and cortisol measures in children.
Main Methods:
- Systematic review of empirical studies.
- Summarized findings on maternal prenatal cortisol and various child outcomes.
- Analyzed potential critical gestational periods.
Main Results:
- A small number of studies found significant associations between maternal prenatal cortisol and altered child outcomes.
- Observed associations include increased physical/health problems, lower cognitive/motor development, more psychological/behavioral issues, and higher child cortisol.
- Heterogeneity in study designs and cortisol assessment methods limits strong conclusions.
Conclusions:
- Maternal prenatal cortisol may influence child development, but likely not as the sole or primary mechanism.
- Critical gestational periods may exist for cortisol's effects.
- Future research needs standardized methods and reporting strategies.
Abstract:
A frequently proposed mechanism underlying the link between maternal prenatal stress/anxiety and child outcomes is heightened concentrations of maternal cortisol. In this systematic review, empirical findings on associations between maternal prenatal cortisol concentrations and child outcomes (physical/health, cognitive/motor, psychological/behavioral, and cortisol) are summarized. The number of empirical studies that find significant associations between maternal prenatal cortisol and child outcomes is small, but the majority of the studies that do find associations show that maternal cortisol is related to altered child outcomes (e.g. more physical/health problems, lower cognitive/motor development, more psychological/behavioral problems, and higher child cortisol concentrations). Inspection of the studies reveals possible critical gestational periods for maternal cortisol to affect different child outcomes. The heterogeneity in study designs and cortisol assessment methods makes drawing strong conclusions premature. However, the fact that most studies did not find significant associations suggests that maternal cortisol may not to be the sole or even main underlying mechanism in the relation between maternal prenatal stress/anxiety and child outcomes. Limitations of the reviewed studies are discussed, and directions for future research and reporting strategies are provided.
