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Prenatal maternal stress, child internalizing and externalizing symptoms, and the moderating role of parenting: findings from the Norwegian mother, father, and child cohort study

Published online by Cambridge University Press:  25 November 2021

Zahra M. Clayborne Open the ORCID record for Zahra M. Clayborne [Opens in a new window] ,
Wendy Nilsen ,
Fartein Ask Torvik ,
Kristin Gustavson ,
Mona Bekkhus ,
Stephen E. Gilman ,
Golam M. Khandaker ,
Deshayne B. Fell  and
Ian Colman
Zahra M. Clayborne*
Affiliation:
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
Wendy Nilsen
Affiliation:
Work Research Institute, OsloMet - Oslo Metropolitan University, Oslo, Norway
Fartein Ask Torvik
Affiliation:
Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway Department of Psychology, University of Oslo, Oslo, Norway
Kristin Gustavson
Affiliation:
Department of Psychology, PROMENTA Research Center, University of Oslo, Oslo, Norway Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
Mona Bekkhus
Affiliation:
Department of Psychology, PROMENTA Research Center, University of Oslo, Oslo, Norway
Stephen E. Gilman
Affiliation:
Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
Golam M. Khandaker
Affiliation:
Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn, UK MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
Deshayne B. Fell
Affiliation:
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
Ian Colman
Affiliation:
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
*
Author for correspondence: Zahra M. Clayborne, E-mail: zclay068@uottawa.ca
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Abstract

Background

Few studies have examined how parenting influences the associations between prenatal maternal stress and children's mental health. The objectives of this study were to examine the sex-specific associations between prenatal maternal stress and child internalizing and externalizing symptoms, and to assess the moderating effects of parenting behaviors on these associations.

Methods

This study is based on 15 963 mother–child dyads from the Norwegian Mother, Father, and Child Cohort Study (MoBa). A broad measure of prenatal maternal stress was constructed using 41 self-reported items measured during pregnancy. Three parenting behaviors (positive parenting, inconsistent discipline, and positive involvement) were assessed by maternal report at child age 5 years. Child symptoms of internalizing and externalizing disorders (depression, anxiety, attention-deficit hyperactivity disorder, conduct disorder, and oppositional-defiant disorder) were assessed by maternal report at age 8. Analyses were conducted using structural equation modeling techniques.

Results

Prenatal maternal stress was associated with child internalizing and externalizing symptoms at age 8; associations with externalizing symptoms differed by sex. Associations between prenatal maternal stress and child depression, and conduct disorder and oppositional-defiant disorder in males, became stronger as levels of inconsistent discipline increased. Associations between prenatal maternal stress and symptoms of attention-deficit hyperactivity disorder in females were attenuated as levels of parental involvement increased.

Conclusions

This study confirms associations between prenatal maternal stress and children's mental health outcomes, and demonstrates that these associations may be modified by parenting behaviors. Parenting may represent an important intervention target for improving mental health outcomes in children exposed to prenatal stress.

Keywords

Externalizingfetal programinginternalizingMoBaparentingprenatal stress
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 6 , April 2023 , pp. 2437 - 2447
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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