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Published on: June 13, 2021
Hair cortisol moderates the association between obstetric complications and child wellbeing
Anna Fuchs1, Katja Dittrich2, Corinne Neukel3
1University Hospital Heidelberg, Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Heidelberg, Germany; Department of Psychology, Pennsylvania State University, University Park, PA, USA.
Insights
Obstetric complications (OC) are linked to child distress. However, low hair cortisol (HC) levels, indicating altered hypothalamus-pituitary-adrenal (HPA)-axis functioning, amplify this risk for behavior problems and reduced quality of life.
Area of Science:
- Developmental Psychology
- Pediatric Health
- Neuroendocrinology
Background:
- Obstetric complications (OC) may impact long-term child health outcomes.
- Limited research exists on the association between OC, child behavior problems, and health-related quality of life (HRQoL).
- The role of the hypothalamus-pituitary-adrenal (HPA)-axis in moderating these associations requires further investigation.
Purpose of the Study:
- To examine the association between obstetric complications (OC) and child distress.
- To investigate the moderating role of hair cortisol (HC) levels, reflecting HPA-axis functioning, in the relationship between OC and child outcomes.
- To assess the impact of OC on child behavior problems and HRQoL.
Main Methods:
- Structural equation modeling was used with data from 232 mother-child dyads (children aged 5-12).
- Obstetric complications were assessed via maternal interviews.
- Child behavior problems (CBCL, TRF) and HRQoL (Kidscreen) were measured, alongside child hair cortisol (HC) levels.
Main Results:
- Obstetric complications (OC) significantly predicted child distress (β = .33, p < .01).
- Hair cortisol (HC) moderated the OC-distress link (β = -.32, p < .01), with significant associations observed only in children with low HC levels.
- This moderation effect was consistent for both externalizing and internalizing behavior problems.
Conclusions:
- Obstetric complications (OC) represent a significant risk factor for child behavior problems and reduced well-being.
- Hair cortisol (HC) levels, indicative of HPA-axis functioning, play a crucial role in mediating the impact of OC on child distress.
- Individual differences in physiological regulation, such as HPA-axis activity, are important in understanding long-term child health trajectories following OC.
Abstract:
Obstetric complications (OC) may have implications for later health outcomes. However, there is a lack of research examining the association between OC and behavior problems or quality of life (HRQoL). We aimed to close this gap and further investigate functioning of the hypothalamus-pituitary-adrenal (HPA)-axis as a potential physiological vulnerability moderating the association between OC and behavior problems and HRQoL. We investigated 232 mothers and their five to 12-year-old children. Presence of OC during the pre-, peri-, and postnatal phases was determined by interviewing mothers. Children's behavior problems (CBCL, TRF) and HRQoL (Kidscreen rated by mothers and children) were assessed. Children gave 3 cm strands of hair for analysis of hair cortisol (HC). Structural equation modeling analyses with a latent variable of child outcome ("distress"), OC as predictor and HC as a potential moderator were conducted. OC significantly predicted distress (β = .33, p < .01). The model showed a good fit to the data: χ2(14)=15.66, p < .33, CFI=.99, TLI=.99, RMSEA=.02, 90 %CI [.00, .06], SRMR=.04. In addition, HC moderated the association between OC and distress (β=-.32, p < .01). The moderation model also showed a good fit: χ2(14) =7.13, p = .93, CFI=1.00, TLI=1.06, RMSEA=.00, 90 %CI [.00, .02], SRMR=.03. Results indicated that the association between OC and distress was significant only when children had low HC-levels. This was also the case for both externalizing and internalizing behavior problems. Our results underline the notion of OC as a risk factor for child behavior problems and wellbeing and point to an important role of the children's physiological set-up such as HPA-functioning.
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