Fetal exposure to placental corticotropin-releasing hormone is associated with child self-reported internalizing symptoms

Abstract

Objective: Fetal exposure to maternal prenatal stress hormones such as cortisol exerts influences on the developing nervous system that persist and include risk for internalizing symptoms later in life. Placental corticotropin-releasing hormone (pCRH) is a feto-placental stress signal that also shapes fetal neurodevelopment and may be a more direct indicator of the fetal experience than maternal stress hormones. The programming effects of pCRH on child development are unknown. The current investigation examined associations between prenatal maternal and placental stress hormone exposures (maternal cortisol and pCRH) and child self-reported internalizing symptoms at age 5.

Method: Maternal plasma cortisol and pCRH levels were measured at 15, 19, 25, 31, and 36 weeks' gestation in a sample of 83 women and their 91 children (8 sibling pairs from separate pregnancies), who were born full-term. Child self-reported internalizing symptoms at age 5 were obtained using scales of the Berkeley Puppet Interview.

Results: Placental CRH profiles (including elevations in mid-gestation) were associated with higher levels of internalizing symptoms at age 5. This effect was not explained by critical prenatal or postnatal influences, including obstetric risk, concurrent maternal psychological state, and family socio-economic status. Prenatal maternal cortisol was not significantly associated with child self-reported internalizing symptoms.

Conclusions: Findings suggest that elevated exposures to the feto-placental stress signal pCRH exert programming effects on the developing fetal central nervous system, with lasting consequences for child mental health.

Keywords: CRH; Cortisol; Fetal programming; Internalizing problems; Pregnancy; Prenatal.

Figure 1

Fetal exposure to trajectories of placental CRH is associated with child report of internalizing symptoms at age 5. Child internalizing symptom scores were treated as a continuous variable for analyses. Trajectories of exposure to placental CRH for children with internalizing symptom scores above or below 1 standard deviation are plotted for illustrative purposes. Inset illustrates gestational window at which acceleration and level of placental CRH concentrations are positively associated with child internalizing symptoms.