Biological and Psychosocial Influences on the Associations Between Prenatal Maternal Stress and Children’s Mental Health Outcomes

Abstract

Mental disorders are highly prevalent and represent an increasingly important public health priority in Canada and globally. Extensive research suggests that exposure to prenatal maternal stress can negatively impact offspring neurodevelopment and mental health. However, the factors that influence the development of mental disorders are varied, and do not occur in isolation. As a result, ascertaining which variables may drive or influence the associations between prenatal stress and mental disorders in children is particularly important, given the substantial burden that is attributed to poor mental health. The overarching aim of this doctoral thesis is to examine how biological and psychosocial factors influence the relationships between prenatal maternal stress and children’s mental health outcomes. Four longitudinal studies were conducted to address this aim, using data from three international prospective birth cohort studies. Analyses comprised of structural equation modelling techniques, including latent moderated structural equation models and mediation analyses. The first two studies utilized data from a Norwegian birth cohort study to examine how parenting and maternal positive mental health, respectively, modified the associations between prenatal maternal stress and children’s internalizing and externalizing symptoms. Broadly, these results demonstrated that positive influences attenuated the associations between prenatal maternal stress and children’s internalizing and externalizing symptoms, whereas negative influences strengthened the associations. The final two studies utilized data from Dutch and British birth cohorts. These studies sought to examine whether maternal and child inflammatory marker concentrations mediated the associations between prenatal maternal stress and children’s mental health outcomes. There was no significant mediation through maternal levels of C-reactive protein during pregnancy, however, the association between prenatal maternal stress and generalized anxiety disorder in adolescence was mediated by children’s levels of interleukin-6. Prenatal maternal stress was consistently associated with children’s mental health across all four studies. This doctoral thesis has identified several important factors that influence the associations between prenatal maternal stress and children’s mental health. Findings can serve to facilitate further research in this area, and ultimately, impact both health policy and clinical practice by stimulating the provision of tailored prevention and intervention efforts that may potentially reduce the burden of poor mental health.