McLean Mia A, Weinberg Joanne, Synnes Anne R, Miller Steven P, Grunau Ruth E
Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
Dev Psychobiol. 2025 Jul;67(4):e70064. doi: 10.1002/dev.70064.
Children born very preterm (≤32 weeks' gestation) are exposed to considerable stress in the neonatal period that, in turn, is associated long-term with altered physiological stress reactivity and regulation, as well as increased internalizing (anxiety and depressive) behaviors. Whether cortisol levels are related to evolving internalizing behaviors in this population has not been evaluated to our knowledge. The present study investigated the association between cortisol reactivity to a cognitive assessment in a novel clinic environment and parent-reported internalizing behaviors both concurrently and across ages in children born very preterm and examined whether relationships differed by biological sex at birth. Total cortisol output (AUCg) and reactivity (AUCi) were calculated from saliva assayed across age-appropriate cognitive tasks, and parents reported on their child's behavior at ages 1.5, 3, and 4.5 years. Valid cortisol data at one or more assessment points were available from 174 participants. Random-intercept cross-lagged panel models showed no longitudinal relationships between internalizing behaviors and cortisol output (AUCg, AUCi). Follow-up multilevel models revealed that the relationship between cortisol AUCg and internalizing behaviors was specific to girls at age 1.5 years. Findings highlight the importance of examining sex differences in biobehavioral relationships across development. Future research should consider factors that may attenuate these relationships across development.
极早产儿（胎龄≤32周）在新生儿期会面临相当大的压力，这反过来又与长期的生理应激反应性和调节改变以及内化（焦虑和抑郁）行为增加有关。据我们所知，该人群中皮质醇水平是否与不断演变的内化行为有关尚未得到评估。本研究调查了在新的临床环境中，极早产儿对认知评估的皮质醇反应性与父母报告的内化行为在不同年龄段的相关性，并研究了这种关系在出生时的生物学性别上是否存在差异。通过对适合各年龄段认知任务的唾液检测计算出总皮质醇输出量（AUCg）和反应性（AUCi），父母报告了孩子在1.5岁、3岁和4.5岁时的行为。174名参与者在一个或多个评估点有有效的皮质醇数据。随机截距交叉滞后面板模型显示内化行为与皮质醇输出量（AUCg、AUCi）之间没有纵向关系。后续的多层次模型显示，皮质醇AUCg与内化行为之间的关系在1.5岁女孩中具有特异性。研究结果凸显了在整个发育过程中研究生物行为关系中性别差异的重要性。未来的研究应考虑可能在整个发育过程中减弱这些关系的因素。
