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Sexually dimorphic and interactive effects of prenatal maternal cortisol and psychological distress on infant cortisol reactivity

Published online by Cambridge University Press:  18 July 2016

Gerald F. Giesbrecht*
University of Calgary
Nicole Letourneau
University of Calgary
Tavis S. Campbell
University of Calgary
The Alberta Pregnancy Outcomes and Nutrition Study Team
University of Calgary
Address correspondence and reprint requests to: Gerald F. Giesbrecht, Department of Paediatrics, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada; E-mail:


In utero exposure to maternal psychological distress is a risk factor for developmental psychopathology, and these effects are believed to partially occur via dysregulation of the maternal and fetal hypothalamus–adrenal–pituitary axes. Nevertheless, only a few human studies have directly assessed the effects of prenatal cortisol exposure on infant cortisol reactivity, and none have investigated sex differences or potential interactions between prenatal cortisol and psychological distress. Here we report on a prospective longitudinal investigation (N = 236) of in utero exposure to maternal cortisol and distress in a relatively high socioeconomic status and low-risk population to determine whether these exposures interact in their effects on infant (M age = 3.0 months, range = 2.3–5.0 months, 51.9% male) cortisol reactivity and whether there are sex differences in these effects. Results revealed both sexually dimorphic and interactive effects of prenatal cortisol and distress, even after controlling for postnatal distress. In general, blunted reactivity in females was associated with exposure to high maternal distress and flattened patterns of diurnal maternal cortisol, whereas blunted reactivity in males was associated with exposure to steeper morning increases and daytime decreases in maternal cortisol. The findings suggest that sex differences in the effects of prenatal cortisol and distress on infant cortisol reactivity are a plausible mechanism by which maternal experiences during pregnancy contribute to sex differences in the development of psychopathology.

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The authors gratefully acknowledge the participants of the Alberta Pregnancy Outcomes and Nutrition (APrON) study and the support of the APrON Study Team, whose individual members are B. J. Kaplan, C. J. Field, D. Dewey, R. C. Bell, F. P. Bernier, M. Cantell, L. M. Casey, M. Eliasziw, A. Farmer, L. Gagnon, G. F. Giesbrecht, L. Goonewardene, D. W. Johnston, L. Kooistra, N. Letourneau, D. P. Manca, J. W. Martin, L. J. McCargar, M. O'Beirne, V. J. Pop, and N. Singhal. This research was supported by grants from Alberta Innovates Health Solutions; the Canadian Institutes of Health Research; the Alberta Center for Child, Family and Community Research; and generous donors of the Alberta Children's Hospital Foundation. The sources of funding had no role in the study design; in the collection, analysis, or interpretation of data; in writing the manuscript; or in the decision to submit the manuscript for publication.


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