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Thinking Across Generations: Unique Contributions of Maternal Early Life and Prenatal Stress to Infant Physiology

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Objective

Respiratory sinus arrhythmia (RSA) is a parasympathetic-mediated biomarker of self-regulation linked to lifespan mental and physical health outcomes. Intergenerational impacts of mothers’ exposure to prenatal stress have been demonstrated, but evidence for biological embedding of maternal preconception stress, including adverse childhood experiences (ACEs), on infant RSA is lacking. We examine the independent effects of maternal ACEs and prenatal stress on infant RSA, seeking to broaden the understanding of the earliest origins of mental and physical health risk.

Method

Mothers reported on ACEs and prenatal stress. RSA was recorded in a sample of 167 4-month-old infants (49% female and 51% male) during a dyadic stressor, the Still Face Paradigm.

Results

Independent contributions of maternal ACEs and prenatal stress to infant RSA were observed. High maternal ACEs were associated with lower RSA, whereas prenatal stress was associated with failure to recover following the stressor. Sex but not race differences were observed. Prenatal stress was associated with higher RSA among boys but lower RSA among girls.

Conclusion

Infants’ RSA is affected by mothers’ life course experiences of stress, with ACEs predicting a lower set point and prenatal stress dampening recovery from stress. For prenatal stress but not ACEs, patterns vary across sex. Findings underscore that stress-reducing interventions for pregnant women or those considering pregnancy may lead to decreased physical and mental health risk across generations.

Section snippets

ANS Activity and Stress Regulation

Emotional and biobehavioral self-regulation is moderated by the interaction of the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS), components of the ANS that work in dynamic balance to promote homeostasis.11, 12 Respiratory sinus arrhythmia (RSA) is an index of PNS activity10 and can be measured by baseline activity, indicating the potential to engage with the environment, or by reactivity, reflecting stimulus response.13 Both baseline and reactivity are

Study Participants

The current report includes 167 infants (49% female) of mothers (61% African American, 39% white) enrolled in a longitudinal study. Recruitment of pregnant women (18–41 years) took place in prenatal and Women, Infant, and Children (WIC) clinics and from other studies. Mothers were >18 years of age (mean = 28.17, SD = 5.82), and only English-speaking mothers were recruited. Gestational age ranged from 32 to 43 weeks (mean = 39.04, SD = 1.63). Twelve infants were born preterm (<37 weeks; 10 late

Results

Correlations and descriptive statistics are presented in Table 1; a total of 113 infants (67%) were low on both ACEs and prenatal stress, 44 (26%) high on one indicator, and 10 (6%) high on both. Boys and girls were equally likely to be classified as high prenatal stress, χ2(2, N = 167) = 0.34, p = .56 (boys n = 18, girls n = 16), and high ACEs, χ2(2, N = 167) = 0.03, p = .86 (boys n = 15, girls n = 15). Prenatal stress and ACEs did not differ between African American and white mothers

Discussion

This study describes how a mother’s exposures across her lifespan influence her offspring’s SRS, likely altering future risk for psychopathology and health. Although both maternal ACEs and prenatal stress predicted infant RSA at 4 months of age, their effects differed. Prenatal stress influenced RSA reactivity over time with infants whose mothers reported high prenatal stress, demonstrating persistent RSA suppression following removal of the stressor, consistent with previous literature.2, 4

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    This article is discussed in an editorial by Dr. James F. Leckman on page 914.

    An interview with the author is available by podcast at www.jaacap.org or by scanning the QR code to the right.

    This research was supported by the National Institutes of Health (NIH) R01MH101533 (S.S.D.), K12HD043451 (S.A.O.G.; PI: Krousel-Wood), and L30HD085275 (S.A.O.G.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

    Disclosure: Dr. Gray has received research funding from the National Institutes of Health, the National Alliance for Research on Schizophrenia and Depression, and the Louisiana Board of Regents. Dr. Theall has received research funding from the National Institutes of Health, the Kellogg Foundation, and the Health Resources and Services Administration. Dr. Drury has received research funding from the National Institutes of Health, the Bill and Melinda Gates Foundation, Tulane University, the Patient-Centered Outcomes Research Institute, the National Science Foundation, and the Substance Abuse and Mental Health Services Administration. Mr. Jones and Ms. Glackin report no biomedical financial interests or potential conflicts of interest.

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