Ahmad Shaikh I, Shih Emily W, LeWinn Kaja Z, Rivera Luisa, Graff J Carolyn, Mason W Alex, Karr Catherine J, Sathyanarayana Sheela, Tylavsky Frances A, Bush Nicole R
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.
Department of Anthropology, Emory University, Atlanta, GA, United States.
Front Psychiatry. 2022 Apr 25;13:838535. doi: 10.3389/fpsyt.2022.838535. eCollection 2022.
Experiences of stress and adversity, such as intimate partner violence, confer risk for psychiatric problems across the life span. The effects of these risks are disproportionately borne by women and their offspring-particularly those from communities of color. The prenatal period is an especially vulnerable period of fetal development, during which time women's experiences of stress can have long-lasting implications for offspring mental health. Importantly, there is a lack of focus on women's capacity for resilience and potential postnatal protective factors that might mitigate these intergenerational risks and inform intervention efforts. The present study examined intergenerational associations between women's prenatal stressors and child executive functioning and externalizing problems, testing maternal parenting quality and child sex as moderators, using a large, prospective, sociodemographically diverse cohort.
We used data from 1,034 mother-child dyads (64% Black, 30% White) from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) pregnancy cohort within the ECHO PATHWAYS consortium. Women's prenatal stressors included stressful life events (pSLE) and intimate partner violence (pIPV). Measures of child psychopathology at age 4-6 included executive functioning and externalizing problems. Parenting behaviors were assessed by trained observers, averaged across two sessions of mother-child interactions. Linear regression models were used to estimate associations between women's prenatal stressors and child psychopathology, adjusting for confounders and assessing moderation effects by maternal parenting quality and child sex.
Women's exposures to pSLE and pIPV were independently associated with child executive functioning problems and externalizing problems in fully-adjusted models. Maternal parenting quality moderated associations between pSLE and both outcomes, such that higher parenting quality was protective for the associations between women's pSLE and child executive functioning and externalizing problems. No moderation by child sex was found.
Findings from this large, sociodemographically diverse cohort suggest women's exposures to interpersonal violence and major stressful events-common for women during pregnancy-may prenatally program her child's executive functioning and externalizing problems. Women's capacity to provide high quality parenting can buffer this intergenerational risk. Implications for universal and targeted prevention and early intervention efforts to support women's and children's wellbeing are discussed.
诸如亲密伴侣暴力等压力和逆境经历会使人在一生中面临精神问题的风险。这些风险对女性及其后代，尤其是有色人种社区的女性及其后代影响尤为严重。孕期是胎儿发育的一个特别脆弱的时期，在此期间女性的压力经历可能会对后代心理健康产生长期影响。重要的是，目前缺乏对女性恢复力以及产后可能减轻这些代际风险并为干预措施提供依据的潜在保护因素的关注。本研究使用一个大型、前瞻性、社会人口统计学特征多样的队列，检验了女性孕期应激源与儿童执行功能及外化问题之间的代际关联，并将母亲养育质量和儿童性别作为调节因素进行了测试。
我们使用了来自ECHO PATHWAYS联盟中影响儿童早期神经认知发育和学习状况（CANDLE）孕期队列的1034对母婴二元组（64%为黑人，30%为白人）的数据。女性的孕期应激源包括生活应激事件（pSLE）和亲密伴侣暴力（pIPV）。4至6岁儿童精神病理学的测量指标包括执行功能和外化问题。养育行为由经过培训的观察员进行评估，在两次母子互动环节中进行平均打分。使用线性回归模型来估计女性孕期应激源与儿童精神病理学之间的关联，对混杂因素进行调整，并评估母亲养育质量和儿童性别对调节效应的影响。
在完全调整后的模型中，女性暴露于pSLE和pIPV分别与儿童执行功能问题和外化问题相关。母亲养育质量调节了pSLE与这两个结果之间的关联，即较高的养育质量对女性pSLE与儿童执行功能及外化问题之间的关联具有保护作用。未发现儿童性别具有调节作用。
来自这个大型、社会人口统计学特征多样的队列的研究结果表明，女性暴露于人际暴力和重大应激事件（孕期女性常见）可能会在产前对其孩子的执行功能和外化问题产生影响。女性提供高质量养育的能力可以缓冲这种代际风险。文中讨论了对支持妇女和儿童福祉的普遍预防和针对性预防及早期干预措施的启示。
