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Updated: Jul 18, 2025

Using a Murine Model of Psychosocial Stress in Pregnancy as a Translationally Relevant Paradigm for Psychiatric Disorders in Mothers and Infants
Published on: June 13, 2021
Associations between prenatal maternal stress, maternal inflammation during pregnancy, and children's internalizing
Zahra M Clayborne1, Runyu Zou2, Stephen E Gilman3
1School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Insights
Maternal stress during pregnancy is linked to children's behavioral symptoms, but not through maternal immune activation. Further research is needed to explore other potential mechanisms.
Area of Science:
- Reproductive Health
- Child Psychology
- Immunology
Background:
- Maternal stress during pregnancy is a potential factor in offspring mental health issues.
- Maternal immune activation is hypothesized to mediate this link.
- Understanding this relationship is crucial for prenatal care and child development.
Purpose of the Study:
- To investigate the association between prenatal maternal stress and child internalizing/externalizing symptoms.
- To examine the role of maternal inflammation (CRP) in this association.
- To determine if maternal inflammation mediates the link between prenatal stress and child behavioral outcomes.
Main Methods:
- Study included 4,902 mother-child dyads from the Generation R study.
- Prenatal maternal stress assessed via self-report; maternal inflammation via C-reactive protein (CRP) levels.
- Child behavioral symptoms measured using the Child Behavior Checklist (CBCL) at ages 3, 5, and 10 years.
Main Results:
- Prenatal maternal stress correlated with child internalizing and externalizing symptoms at multiple time points.
- Maternal CRP levels showed associations with child symptoms before covariate adjustment, but not after.
- No evidence found for CRP mediating the relationship between prenatal stress and child behavioral outcomes.
Conclusions:
- Prenatal maternal stress is associated with increased child behavioral symptoms.
- Maternal immune activation (CRP) does not appear to mediate this association.
- Further research should explore alternative biomarkers and immune variations during pregnancy.
Background:
Maternal immune activation is a potential mechanism underlying associations between maternal stress during pregnancy and offspring mental health problems. This study examined associations between prenatal maternal stress, maternal inflammation during pregnancy, and children's internalizing and externalizing symptoms from 3 to 10 years of age, and whether maternal inflammation mediated the associations between prenatal maternal stress and children's internalizing and externalizing symptoms.
Methods:
This study comprised 4,902 mother-child dyads in the Generation R study. Prenatal maternal stress was assessed using self-reported data collected during pregnancy and analyzed as a latent variable consisting of four stress domains. Maternal inflammation during pregnancy was assessed using serum concentrations of C-reactive protein (CRP) measured at a median of 13.5 weeks' gestation. Child internalizing and externalizing symptoms were assessed using the Child Behavior Checklist (CBCL) by maternal report at ages 3 years, 5 years, and 10 years; paternal-reported CBCL data were also available at 3 years and 10 years.
Results:
Prenatal maternal stress was associated with maternal-reported internalizing and externalizing symptoms of the child at 3, 5, and 10 years of age, and with paternal-reported internalizing and externalizing symptoms at 3 and 10 years. Prenatal maternal stress was associated with maternal CRP concentrations prior to, but not after, covariate adjustment. Maternal CRP concentrations during pregnancy were associated with paternal-reported internalizing symptoms of offspring at 10 years of age prior to, but not after, covariate adjustment. There was no evidence that CRP concentrations mediated the associations between prenatal maternal stress and children's internalizing or externalizing symptoms.
Conclusions:
Maternal stress during pregnancy is associated with higher levels of internalizing and externalizing symptoms in children, but this association is not because of differences in maternal immune activation linked to maternal stress. Replication of these findings in other cohorts is required; examination of other biomarkers or variation in immune activity during pregnancy would also benefit from further exploration.
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