Prenatal exposure to social adversity and infant cortisol in the first year of life

Figures & data

Table 1. Measures and timing of data collection.

Measure	Data source	3rd trimester	1-month postnatal	6-month postnatal	12-month postnatal
Infant cortisol	Saliva		X	X	X
Prenatal stressors (CRISYS-R)	Survey	X		X	X
Prenatal economic hardship	Survey	X
Mother’s age/self-reported race	Survey	X
Infant gestational age/assigned sex	EHR		X
Obstetric risk score	EHR		X
Neonatal risk score (MAIN)	EHR		X
Depression score (PHQ-9)	Survey	X		X	X
Perceived stress (PSS-10)	Survey	X		X	X

Table 2. Demographic and health characteristics of the sample (N = 189).

Age of mother in years, median (IQR)	34.00 (31.00, 38.00)
Gestational age of infant in weeks, median (IQR)	37.10 (34.80, 39.15)
Female assigned-sex of infant, n (%)	88.00 (46.56)
Self-reported race of mother, n (%)
American Indian/Alaskan native	1.00 (0.53)
Asian	30.00 (15.87)
Black/African-American	35.00 (18.52)
Hawaiian/Pacific Islander	3.00 (1.59)
Hispanic/Latinx	48.00 (25.40)
White/European (non-Latinx)	65.00 (34.39)
Unknown/not reported	7.00 (3.70)
Obstetric risk score, median (IQR)	3.00 (2.00, 5.00)
Neonatal morbidity score, median (IQR)	0.00 (0.00, 151.00)
Prenatal depression symptom score, median (IQR)	4.00 (2.00, 9.00)
Prenatal perceived stress score, median (IQR)	14.50 (11.00, 20.00)
Infant cortisol concentration – µg/dL, median (IQR)
1-month postnatal	0.32 (0.19, 0.56)
6-month postnatal	0.23 (0.15, 0.42)
12-month postnatal	0.20 (0.11, 0.49)
Prenatal economic hardship (N = 157), n (%)	77.00 (49.04)
Number of prenatal stressors, median (IQR)	5.00 (3.00, 8.00)

IQR: interquartile range

Median (IQR) presented to account for variables with positively skewed distribution of data.

Table 3. Univariate analysis of effects of prenatal social adversity on infant resting cortisol (N = 189).

	Estimate	CI Lower	CI Upper	p
1-month postnatal
Number of prenatal stressors	−0.09	−0.33	0.14	0.43
Prenatal exposure to economic hardship	−0.46	−0.88	−0.04	0.03*
6-month postnatal
Number of prenatal stressors	−0.008	−0.42	0.40	0.97
Prenatal exposure to economic hardship	0.96	0.45	1.49	0.0003*
12-month postnatal
Number of prenatal stressors	0.03	−0.53	0.60	0.90
Prenatal exposure to economic hardship	0.76	0.15	1.37	0.01*

* Denotes statistical significance at p < 0.05.

Figure 1. Marginal means of infant cortisol at 1, 6, and 12 months postnatal, by economic hardship exposure. Error bars represent 95% confidence intervals.

Table 4. Linear mixed model effects of prenatal exposure to economic hardship on infant resting cortisol over first postnatal year (N = 189).

	Estimate	CI Lower	CI Upper	p
Time
6-month postnatal	−1.02	−2.94	0.90	0.30
12-month postnatal	2.58	0.45	4.71	0.018*
Age of mother/birthing person × time
1-month postnatal	0.01	−0.03	0.05	0.71
6-month postnatal	0.01	−0.04	0.06	0.61
12-month postnatal	−0.08	−0.14	−0.03	0.0041*
Prenatal economic hardship × time
1-month postnatal	−0.35	−0.81	0.12	0.15
6-month postnatal	0.98	0.35	1.60	0.0027*
12-month postnatal	0.17	−0.51	0.85	0.63

1 month: reference.

* Denotes statistical significance at p < 0.05.

Table 5. Characteristics of dyads by prenatal exposure to economic hardship (N = 157).

	Hardship	No hardship
	(N = 77)	(N = 80)	p
Age of mother in years, median (IQR)	31.00 (26.00, 35.00)	36.00 (34.00, 40.00)	<0.001
Gestational age of infant in weeks, median (IQR)	37.15 (35.20, 39.05)	37.25 (34.25, 39.30)	0.72
Female assigned-sex of infant, n (%)	32.00 (41.56)	48.00 (60.00)	0.02
Self-reported race of mother, n (%)
American Indian/Alaskan native	1.00 (1.30)	0.00 (0.00)	0.30
Asian	4.00 (5.19)	22 (27.50)	<0.001
Black/African-American	30.00 (38.96)	2.00 (2.50)	<0.001
Hawaiian/Pacific Islander	3.00 (3.90)	0.00 (0.00)	0.07
Hispanic/Latinx	31.00 (40.26)	3.00 (3.75)	<0.001
White/European (non-Latinx)	5.00 (6.49)	51.00 (63.75)	<0.001
Unknown/Not reported	3.00 (3.90)	2.00 (2.50)	0.61
Obstetric risk score, median (IQR)	4.00 (2.00, 5.00)	3.00 (2.00, 5.00)	0.41
Neonatal morbidity score, median (IQR)	0.00 (0.00, 115.00)	0.00 (0.00, 151.00)	0.49
Prenatal depression symptom score, median (IQR)	7.50 (4.00, 11.00)	3.00 (2.00, 6.00)	<0.001
Prenatal perceived stress score, median (IQR)	17.00 (11.00, 22.00)	13.00 (8.00, 17.00)	<0.001
Infant cortisol concentration – µg/dL, median (IQR)
1-month postnatal	0.25 (0.17, 0.48)	0.37 (0.21, 0.81)	0.01
6-month postnatal	0.27 (0.17, 0.54)	0.19 (0.13, 0.26)	0.005
12-month postnatal	0.21 (0.10, 0.42)	0.16 (0.11, 0.36)	0.40
Number of prenatal stressors, median (IQR)	8.00 (5.00, 12.00)	4.00 (3.00, 5.50)	<0.001

IQR: interquartile range

Median (IQR) presented to account for variables with positively skewed distribution of data.