Elsevier

Infant Behavior and Development

Volume 40, August 2015, Pages 204-215
Infant Behavior and Development

Foetal programming and cortisol secretion in early childhood: A meta-analysis of different programming variables

https://doi.org/10.1016/j.infbeh.2015.04.004Get rights and content

Abstract

It is widely recognized that different events may take place in the intrauterine environment that may influence later developmental outcome. Scholars have long postulated that maternal prenatal stress, alcohol or drug use, and cigarette smoking may impact foetal formation of the hypothalamus–pituitary–adrenal (HPA) axis, which may later influence different aspects of early childhood socioemotional and cognitive development. However, results linking each of these factors with child cortisol secretion have been mixed. The current meta-analysis examined the relation between each of these programming variables and child cortisol secretion in studies conducted up to December 31st, 2012. Studies were included if they were conducted prior to child age 60 months, and if they reported an index of effect size linking either maternal prenatal stress, alcohol or drug use, or cigarette smoking with an index of child cortisol secretion. In total, 19 studies (N = 2260) revealed an average effect size of d = .36 (p < .001). Moderator analyses revealed that greater effect sizes could be traced to maternal alcohol use, to the use of retrospective research methodology, where mothers are questioned after childbirth regarding programming variables, and to the use of baseline measures of cortisol secretion, as opposed to recovery measures. Discussion focuses on processes that link the environment to foetal development and how both are linked to later adaptation.

Section snippets

Foetal programming and HPA axis activity

Recent research has underlined the influence that foetal programming may have on development during childhood and across the lifespan (O’Connor, 2003). At least one of the mechanisms by which foetal programming is thought to take place involves prenatal influences on the development of the hypothalamic-pituitary-adrenal system (HPA; Beijers et al., 2014, Glover et al., 2010, Loman and Gunnar, 2010, Meaney et al., 2007). The HPA axis provides the physiological infrastructure for cortisol

Cortisol secretion and developmental outcome

Studies have confirmed that variations in cortisol secretion are related to individual differences in socioemotional and cognitive outcome. Cicchetti and Rogosch (2001) found that maltreated children with major behaviour problems showed greater levels of baseline cortisol secretion than those without behaviour problems. Susman (2006) showed that both atypically low and high circadian rhythms of cortisol secretion are related to child and adolescent antisocial behaviour and conduct disorder.

Programming factors

Much of the recent research on foetal programming factors has focused on maternal prenatal stress and anxiety (PSA), as well as on certain substances that expectant mothers might use, such as alcohol, drugs and tobacco. These very different programming factors have all been postulated to impact the intra-uterine development of the HPA axis. However, little work has sought to determine whether their relation to cortisol secretion during infancy and early childhood are of the same magnitude. The

Moderating variables

At least four methodological issues may be at stake in the relation between programming variables and early childhood cortisol secretion: (1) the kind of programming factor (PSA, alcohol, tobacco, different drug use). While it is true that these variables are different from one another and relate to different physiological processes, they may nevertheless be compared within a meta-analytic context where the comparisons are based on the strength of associations; (2) the type of cortisol

Eligibility criteria

A study was included if:

  • It included at least one assessment of one of the above-mentioned programming variables (PSA, alcohol, drug, or tobacco use).

  • It included at least one measure of child cortisol secretion, when children were between 0 and 60 months. If several articles presented data on the same sample, the article that reported on the largest number of participants was retained.

  • An appropriate index of the relation between programming variable and cortisol secretion was available for

Study selection

The initial search yielded 4304 articles, of which 18 were retained. Reference lists allowed for the identification of an additional 2609 articles, of which only one was retained. The current meta-analysis is thus based on data provided by 19 studies, involving 2260 participants (Fig. 1). Sample size varied from 14 to 422. Study characteristics are presented in Table 1.

Main effects

The relation between programming variables and cortisol secretion is d = .36 (p < .001, k = 19). Effect estimates for each study,

Discussion

The results of the present meta-analysis underline three points. First, there is strong support for the foetal programming hypothesis. All programming variables were related to baseline and reactive cortisol secretion, suggesting that indices of HPA axis activity are solid indicators of the mechanisms by which foetal programming may influence developmental outcome. These results provide an important level of support for the hypothesis that programming factors influence development by way of

Acknowledgements

This study was made possible through funding from the Canadian Institutes of Health Research to the first author and from the Québec Society and Culture Research Fund to the first and second authors (Fonds de recherche du Québec – Société et Culture).

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