Early Adversity, Socioemotional Development, and Stress in Urban 1-Year-Old Children

• Published in: The Journal of pediatrics Vol. 163; no. 6; pp. 1733 - 1739.e1
• Main Authors: Palmer, Frederick B., MD, Anand, Kanwaljeet J.S., MBBS, DPhil, Graff, J. Carolyn, PhD, Murphy, Laura E., EdD, Qu, Yanhua, PhD, Völgyi, Eszter, PhD, Rovnaghi, Cynthia R., MS, Moore, Angela, MPH, Tran, Quynh T., PhD, Tylavsky, Frances A., DrPH
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2013; Mosby, Inc
• Subjects: Age Factors; Blacks; Child Development; childhood; children; cortisol; distress; education; Emotions; Female; Hair - chemistry; Humans; Hydrocortisone - analysis; income; Infant; insurance; Male; mental depression; mental health; mothers; parenting; Pediatrics; Prospective Studies; regression analysis; Risk Factors; Socioeconomic Factors; Stress, Psychological - epidemiology; Urban Health; Whites; Tennessee; CANDLE; Brief Symptom Inventory; BITSEA; Hypothalamic-pituitary-adrenal; Socioemotional; Temperament Evaluation of Memphis, Pisa, Paris, and San Diego; SE; Brief Infant-Toddler Social and Emotional Assessment; Edinburgh Postnatal Depression Scale; HPA; BSI; EPDS; Conditions Affecting Neurocognitive Development and Learning in Early Childhood; TEMPS
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2013.08.030

Objective To determine demographic, maternal, and child factors associated with socioemotional (SE) problems and chronic stress in 1-year-old children. Study design This was a prospective, longitudinal, community-based study, which followed mother-infant dyads (n = 1070; representative of race, education, and income status of Memphis/Shelby County, Tennessee) from midgestation into early childhood. Child SE development was measured using the Brief Infant-Toddler Social and Emotional Assessment in all 1097 1-year-olds. Chronic stress was assessed by hair cortisol in a subsample of 1-year-olds (n = 297). Multivariate regression models were developed to predict SE problems and hair cortisol levels. Results More black mothers than white mothers reported SE problems in their 1-year-olds (32.9% vs 10.2%; P < .001). In multivariate regression, SE problems in blacks were predicted by lower maternal education, greater parenting stress and maternal psychological distress, and higher cyclothymic personality score. In whites, predictors of SE problems were Medicaid insurance, higher maternal depression score at 1 year, greater parenting stress and maternal psychological distress, higher dysthymic personality score, and male sex. SE problem scores were associated with higher hair cortisol levels ( P = .01). Blacks had higher hair cortisol levels than whites ( P < .001). In the entire subsample, increased hair cortisol levels were associated with higher parenting stress ( P = .001), lower maternal depression score ( P = .01), lower birth length ( P < .001), and greater length at 1 year of age ( P = .003). Conclusion Differences in maternal education, insurance, mental health, and early stress may disrupt SE development in children. Complex relationships between hair cortisol level in 1-year-olds and maternal parenting stress and depression symptoms suggest dysregulation of the child's hypothalamic-pituitary-adrenal axis.