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The evidence supporting the idea that natural disaster-related prenatal maternal stress (PNMS) influences the child's development has been accumulating for several years. We conducted a meta-analytical review to quantify this effect on different spheres of child development: birth outcomes, cognitive, motor, physical, socio-emotional, and behavioral development. We systematically searched the literature for articles on this topic (2756 articles retrieved and 37 articles included in the systematic review), extracted the relevant data to calculate the effect sizes, and then performed a meta-analysis for each category of outcomes (30 articles included across the meta-analyses) and meta-regressions to determine the effect of some factors of interest on the association between PNMS and child development: type of PNMS (objective, psychological, cognitive, diet), type of natural disaster (ice storm, flood/cyclone), type of report (maternal, third-party observer, medical), timing of exposure (preconception exposure included or not) and child age at assessment (under 10 or 10 years and older). We found that PNMS significantly influences all spheres of child development. Higher PNMS levels were associated with longer gestational age, larger newborns, and higher BMI and adiposity levels, as well as worse cognitive, motor, socio-emotional, and behavioral outcomes.

Background: Research shows that continuity of midwifery carer in pregnancy improves maternal and neonatal outcomes. This study examines whether midwifery group practice (MGP) care during pregnancy affects infant neurodevelopment at 6-months of age compared to women receiving standard hospital maternity care (SC) in the context of a natural disaster., Methods: This prospective cohort study included 115 women who were affected by a sudden-onset flood during pregnancy. They received one of two models of maternity care: MGP or SC. The women's flood-related objective stress, subjective reactions, and cognitive appraisal of the disaster were assessed at recruitment into the study. At 6-months postpartum they completed the Ages and Stages Questionnaire (ASQ-3) on their infants' communication, fine and gross motor, problem solving, and personal-social skills., Results: Greater maternal objective and subjective stress predicted worse infant outcomes. Even when controlling for maternal stress from the flood, infants of mothers who were in the MGP model of maternity care performed better than infants of mothers in SC on two of the five ASQ-3 domains (fine motor and problem solving) at 6-months of age. Furthermore, infants in the SC model were more likely to be identified as at risk for delayed development on these domains than infants in the MGP model of care., Conclusions: Continuity of midwifery care has positive effects on infant neurodevelopment when mothers experience disaster-related stress in pregnancy, with significantly better outcomes on two developmental domains at 6 months compared to infants whose mothers received standard hospital care.

Fetal exposure to prenatal maternal stress can have lifelong consequences, with different types of maternal stress associated with different areas of child development. Fewer studies have focused on motor skills, even though they are strongly predictive of later development across a range of domains. Research on mechanisms of transmission has identified biological cascades of stress reactions, yet links between psychological stress reactions are rarely studied. This study investigates the relationship between different aspects of disaster-related prenatal maternal stress and child cognitive and motor development, and proposes a cascade of stress reactions as a potential mechanism of transmission. Mothers in the Queensland Flood Study (QF2011) exposed to a major flood during pregnancy completed questionnaires assessing flood exposure, symptoms of peritraumatic distress, dissociation, and posttraumatic stress (PTSD), and cognitive appraisal of the overall flood consequences. At 16 months post-partum, children's (N = 145) cognitive and motor development was assessed using the Bayley-III. Flood exposure predicted child cognitive development and maternal PTSD symptoms and negative cognitive appraisal were significantly negatively related to child motor development, with all relationships moderated by timing of exposure. Together, a cascade of stress reactions linked maternal flood exposure to poorer fine motor development. These findings suggest that the way stress reactions operate together is as important as the way they operate in isolation, and identifies a potential psychological mechanism of transmission for the effects of prenatal stress. Results have implications for conceptualizing prenatal stress research and optimizing child development in the wake of natural disasters.

The study used data from Project Ice Storm to determine the extent to which exposure to prenatal maternal stress due to a natural disaster can explain variance in the intellectual and language performance of offspring at age 5 1/2.

Toddler toy play evolves in a predictable manner and provides a valid, nonverbal measure of cognitive function unbiased by social behaviors. Research on prenatal maternal stress (PNMS) indicates that exposure to stress in utero results in developmental deficits. We hypothesized that children exposed to high objective PNMS from a natural disaster early in pregnancy would exhibit higher rates of stereotypical play and lower rates of mature functional play than their low-stress counterparts would. We examined the functional play abilities of 52 2-year-olds exposed to low or high objective PNMS from a natural disaster within a nonstructured play session. Toddlers exposed to high objective PNMS, subjective PNMS, or both exhibited less functional and more stereotypical toy play, with less diversity, compared to toddlers exposed to low PNMS. PNMS appears to affect functional play development in toddlers negatively. These results replicate delays in language and intellectual functioning observed in these toddlers using the Bayley Scales. (Contains 3 tables and 2 figures.)

Prenatal stress alters fetal programming, potentially predisposing the ensuing offspring to long-term adverse health outcomes. To gain insight into environmental influences on fetal development, this QF2011 study evaluated the urinary metabolomes of 4-year-old children (n = 89) who were exposed to the 2011 Queensland flood in utero. Proton nuclear magnetic resonance spectroscopy was used to analyze urinary metabolic fingerprints based on maternal levels of objective hardship and subjective distress resulting from the natural disaster. In both males and females, differences were observed between high and low levels of maternal objective hardship and maternal subjective distress groups. Greater prenatal stress exposure was associated with alterations in metabolites associated with protein synthesis, energy metabolism, and carbohydrate metabolism. These alterations suggest profound changes in oxidative and antioxidative pathways that may indicate a higher risk for chronic non-communicable diseases such obesity, insulin resistance, and diabetes, as well as mental illnesses, including depression and schizophrenia. Thus, prenatal stress-associated metabolic biomarkers may provide early predictors of lifetime health trajectories, and potentially serve as prognostic markers for therapeutic strategies in mitigating adverse health outcomes. [ABSTRACT FROM AUTHOR]

Numerous studies have shown associations between maternal stress and poor birth outcomes, but evidence is unclear for causal inference. Natural disasters provide an opportunity to study effects of quasi-randomized hardship with an accurate measure of onset and duration. In a population-based quasi-experimental study, we examined the effect of maternal exposure to the January 1998 Québec ice storm on birth outcomes by comparing pregnant mothers who lived in an area hard hit by the ice storm with those in two unaffected regions. In a total of 147,349 singleton births between 1995 and 2001, we used a difference-in-differences method to estimate the effects of the ice storm on gestational age at delivery (GA), preterm birth (PTB), weight-for-gestational-age z-scores (BWZ), large for gestational age (LGA), and small for gestational age (SGA). After adjusting for maternal and sociodemographic characteristics, there were no differences between the exposed and the unexposed mothers for birth outcomes. The estimated differences (exposed vs. unexposed) were 0.01 SDs (95% CI: −0.02, 0.05) for BWZ; 0.10% point (95% CI: −0.95%, 1.16%) for SGA; 0.25% point (95% CI: −0.78%, 1.28%) for LGA; −0.01 week (95% CI: −0.07, 0.05) for GA; and 0.16% point (95% CI: −0.66%, 0.97%) for PTB. Neither trimester-specific nor dose–response associations were observed. Overall, exposure to the 1998 Québec ice storm as a proxy for acute maternal stress in pregnancy was not associated with poor birth outcomes. Our results suggest that acute maternal hardship may not have a substantial effect on adverse birth outcomes. [ABSTRACT FROM AUTHOR]

Gene-by-environment interactions influence brain development from conception to adulthood. In particular, the prenatal period is a window of vulnerability for the interplay between environmental and genetic factors to influence brain development. Rodent and human research demonstrates that prenatal maternal stress (PNMS) alters hippocampal volumes. Although PNMS affects hippocampal size on average, similar degrees of PNMS lead to different effects in different individuals. This differential susceptibility to the effects of PNMS may be due to genetic variants. Hence, we investigated the role of genetic variants of two SNPs that are candidates to moderate the effects of PNMS on hippocampal volume: COMT (rs4680) and BDNF (rs6265). To investigate this, we assessed 53 children who were in utero during the January 1998 Quebec ice storm. In June 1998 their mothers responded to questionnaires about their objective, cognitive, and subjective levels of stress from the ice storm. When children were 11 1/2 years old, T1-weighted structural magnetic resonance imaging (MRI) scans were obtained using a 3T scanner and analyzed to determine hippocampal volumes. We collected and genotyped the children's saliva DNA. Moderation analyses were conducted to determine whether either or both of the SNPs moderate the effect of PNMS on hippocampal volumes. We found that objective hardship was associated with right hippocampal volume in girls, and that the BDNF and COMT genotypes were associated with left hippocampal volume in boys and girls. In addition, SNPs located on COMT moderated the effect of maternal objective distress in boys, and subjective distress in girls, on both right hippocampal volume. Thus, we conclude that an individual's genotype alters their susceptibility to the effects of PNMS. [ABSTRACT FROM AUTHOR]

Poor postnatal mental health is a major public health issue, and risk factors include experiencing adverse life events during pregnancy. We assessed whether midwifery group practice, compared to standard hospital care, would protect women from the negative impact of a sudden-onset flood on postnatal depression and anxiety. Women either received midwifery group practice care in pregnancy, in which they were allocated a primary midwife who provided continuity of care, or they received standard hospital care provided by various on-call and rostered medical staff. Women were pregnant when a sudden-onset flood severely affected Queensland, Australia, in January 2011. Women completed questionnaires on their flood-related hardship (objective stress), emotional reactions (subjective stress), and cognitive appraisal of the impact of the flood. Self-report assessments of the women’s depression and anxiety were obtained during pregnancy, at 6 weeks and 6 months postnatally. Controlling for all main effects, regression analyses at 6 weeks postpartum showed a significant interaction between maternity care type and objective flood-related hardship and subjective stress, such that depression scores increased with increasing objective and subjective stress with standard care, but not with midwifery group practice (continuity), indicating a buffering effect of continuity of midwifery carer. Similar results were found for anxiety scores at 6 weeks, but only with subjective stress. The benefits of midwifery continuity of carer in pregnancy extend beyond a more positive birth experience and better birthing and infant outcomes, to mitigating the effects of high levels of stress experienced by women in the context of a natural disaster on postnatal mental health. [ABSTRACT FROM AUTHOR]

Research shows that prenatal maternal stress (PNMS) negatively affects a range of infant outcomes; yet no single study has explored the effects of stress in pregnancy from a natural disaster on multiple aspects of infant neurodevelopment. This study examined the effects of flood-related stress in pregnancy on 6-month-olds' neurodevelopment and examined the moderating effects of timing of the stressor in gestation and infant sex on these outcomes. Women exposed to the 2011 Queensland (Australia) floods in pregnancy completed surveys on their flood-related objective and subjective experiences at recruitment and reported on their infants' neurodevelopment on the problem solving, communication, and personal-social scales of the Ages and Stages- III at 6 months postpartum ( N = 115). Interaction results showed that subjective flood stress in pregnancy had significantly different effects in boys and girls, and that at high levels of stress girls had significantly lower problem solving scores than boys. Timing of the flood later in pregnancy predicted lower personal-social scores in the sample, and there was a trend ( p < .10) for greater objective flood exposure to predict lower scores. PNMS had no effect on infants' communication skills. In conclusion, differential aspects of maternal flood-related stress in pregnancy influenced aspects of 6-month-olds' neurodevelopment. [ABSTRACT FROM AUTHOR]

Disaster exposure during pregnancy has received limited attention. This study examined the impact of the 2008 Iowa Floods on perinatal maternal depression and well-being, and the role of peritraumatic distress as a possible mechanism explaining this link. Perinatal women (N = 171) completed measures of depressive symptoms and general well-being at 5 timepoints from pregnancy to 30 months postpartum. Objectively assessed prenatal flood exposure was associated with greater depression (r = .15). Further, flood-related peritraumatic distress was uniquely associated with greater depression (r = .23), and was a key mechanism through which flood exposure led to depression. Prenatal flood exposure was also associated with general well-being (r = .18); however, a mechanism other than peritraumatic distress appears to have been responsible for the effect of flood exposure on well-being. We discuss the implications of these findings for informing etiological models and enhancing the efficacy of interventions for maternal psychopathology. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Research associates maternal stress exposures (especially when occurring late in gestation) with heightened risk of subsequent emotional and behavioral problems in affected offspring. However, as yet, no study has examined the association between prenatal maternal stress (PNMS) and affected children's risk of anorexia- or bulimia-type eating disturbances. Objective To study the influences of PNMS on later disordered eating in exposed offspring. Method We used the Eating Attitudes Test (EAT)-26 to measure eating attitudes and behaviors in 54 thirteen-year olds whose mothers had been exposed, while pregnant with these children, to the 1998 Quebec Ice Storm-a natural disaster regarded as a model of exposure to severe environmental stress. Mothers' stress was measured shortly after exposure to the storm using established indices of objective and subjective stress. Results Hierarchical multiple linear regression analyses indicated that once variance owing to children's body mass index and sex was accounted for, stress exposures during the third trimester of pregnancy predicted elevated EAT-26 scores in affected children-perhaps even more so when levels of objective stress were high. Discussion Third trimester exposure to PNMS, especially when objectively severe, seems to be associated with increased eating-disorder-linked manifestations in affected early adolescents. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:512-516) [ABSTRACT FROM AUTHOR]

Background: Retrospective studies suggest that maternal exposure to a severe stressor during pregnancy increases the fetus' risk for a variety of disorders in adulthood. Animal studies testing the fetal programming hypothesis find that maternal glucocorticoids pass through the placenta and alter fetal brain development, particularly the hypothalamic-pituitary-adrenal axis. However, there are no prospective studies of pregnant women exposed to a sudden-onset independent stressor that elucidate the biopsychosocial mechanisms responsible for the wide variety of consequences of prenatal stress seen in human offspring. The aim of the QF2011 Queensland Flood Study is to fill this gap, and to test the buffering effects of Midwifery Group Practice, a form of continuity of maternity care. Methods/design: In January 2011 Queensland, Australia had its worst flooding in 30 years. Simultaneously, researchers in Brisbane were collecting psychosocial data on pregnant women for a randomized control trial (the M@NGO Trial) comparing Midwifery Group Practice to standard care. We invited these and other pregnant women to participate in a prospective, longitudinal study of the effects of prenatal maternal stress from the floods on maternal, perinatal and early childhood outcomes. Data collection included assessment of objective hardship and subjective distress from the floods at recruitment and again 12 months post-flood. Biological samples included maternal bloods at 36 weeks pregnancy, umbilical cord, cord blood, and placental tissues at birth. Questionnaires assessing maternal and child outcomes were sent to women at 6 weeks and 6 months postpartum. The protocol includes assessments at 16 months, 2½ and 4 years. Outcomes include maternal psychopathology, and the child's cognitive, behavioral, motor and physical development. Additional biological samples include maternal and child DNA, as well as child testosterone, diurnal and reactive cortisol. Discussion: This prenatal stress study is the first of its kind, and will fill important gaps in the literature. Analyses will determine the extent to which flood exposure influences the maternal biological stress response which may then affect the maternal-placental-fetal axis at the biological, biochemical, and molecular levels, altering fetal development and influencing outcomes in the offspring. The role of Midwifery Group Practice in moderating effects of maternal stress will be tested. [ABSTRACT FROM AUTHOR]

Background: Prenatal maternal stress (PNMS) predicts a wide variety of behavioral and physical outcomes in the offspring. Although epigenetic processes may be responsible for PNMS effects, human research is hampered by the lack of experimental methods that parallel controlled animal studies. Disasters, however, provide natural experiments that can provide models of prenatal stress. Methods: Five months after the 1998 Quebec ice storm we recruited women who had been pregnant during the disaster and assessed their degrees of objective hardship and subjective distress. Thirteen years later, we investigated DNA methylation profiling in T cells obtained from 36 of the children, and compared selected results with those from saliva samples obtained from the same children at age 8. Results: Prenatal maternal objective hardship was correlated with DNA methylation levels in 1675 CGs affiliated with 957 genes predominantly related to immune function; maternal subjective distress was uncorrelated. DNA methylation changes in SCG5 and LTA, both highly correlated with maternal objective stress, were comparable in T cells, peripheral blood mononuclear cells (PBMCs) and saliva cells. Conclusions: These data provide first evidence in humans supporting the conclusion that PNMS results in a lasting, broad, and functionally organized DNA methylation signature in several tissues in offspring. By using a natural disaster model, we can infer that the epigenetic effects found in Project Ice Storm are due to objective levels of hardship experienced by the pregnant woman rather than to her level of sustained distress. [ABSTRACT FROM AUTHOR]

Background: Limited research has evaluated distinct aspects of disaster experience as predictors of affective symptoms. In this study, we examined the extent to which maternal depression and anxiety over time were predicted by (1) objective hardship from a flood during pregnancy, (2) peritraumatic distress and (3) cognitive appraisal of the flood's consequences.Methods: Data were drawn from the 2011 Queensland Flood Study, a prospective, longitudinal study of pregnancy (n = 183). Mothers' disaster experience was measured within 1 year after the flood. Their levels of depression, anxiety and stress were measured at 16 months, 30 months, 4 years and 6 years after childbirth. Linear mixed models were employed to evaluate symptom trajectories.Results: There were no time-dependent effects of disaster-related variables. Objective hardship did not predict outcomes. Peritraumatic distress significantly predicted depression and anxiety symptoms when cognitive appraisal was negative. Conversely, when cognitive appraisal was neutral or positive, the effect of peritraumatic distress was "buffered". For anxiety, but not depression, this interaction survived Bonferroni correction. Neutral/positive cognitive appraisal similarly moderated the effect of peritraumatic dissociation.Limitations: The generalizability of our findings is limited by overall low levels of depression and anxiety, along with a predominantly Caucasian, higher socioeconomic status sample. Potential confounders such as pre-disaster anxiety were not controlled for.Conclusion: In line with previous evidence, this study supports the predictive validity of peritraumatic distress for post-disaster depression and anxiety. Our findings suggest that cognitive appraisal could be a relevant target for interventions aimed at fostering maternal resilience. [ABSTRACT FROM AUTHOR]

Prenatal maternal stress can adversely affect birth outcomes, likely reflecting effects of maternal stress hormones on fetal development. Maternal stress might also induce behavioural changes, such as dietary change, that might influence fetal development. Few studies have documented relationships between stress and dietary change in pregnancy. We analysed stress and dietary change among 222 pregnant women exposed to the 2011 Queensland Floods. We assessed women's objective hardship, subjective distress and cognitive appraisal of the disaster; changes in their diets and their associations with infants' gestational age, weight, length and head circumference at birth, head circumference to birth length ratio (HC/BL) and ponderal index. Greater objective hardship was correlated with more negative dietary change, skipped meals and skipped multivitamins. There were no direct effects of stress or dietary change on birth outcomes. However, we observed an interactive effect of dietary change and exposure timing on head circumference for gestational age (HC for GA) ( p = 0.010) and a similar trend for HC/BL ( p = 0.064). HC for GA and HC/BL were larger among children whose mothers experienced negative changes to their diet in early pregnancy compared with later pregnancy, consistent with a 'head-sparing' response with early gestation exposure. Further analyses indicated that dietary change mediates the relationship between objective hardship because of the floods and these outcomes. This is the first report of relationships among an independent stressor, dietary change and birth outcomes. It highlights another possible mechanism in the relationship between prenatal maternal stress and child development that could guide future research and interventions. [ABSTRACT FROM AUTHOR]

Dermatoglyphic asymmetry of fingertip ridge counts is more frequent in schizophrenia patients than normal controls, and may reflect disruptions in fetal development during Weeks 14-22 when fingerprints develop. However, there are no data in humans linking specific adverse events at specific times to dermatoglyphic asymmetries. Our objective was to determine whether prenatal exposure to a natural disaster (1998 Quebec ice storm) during Weeks 14-22 would result in increased dermatoglyphic asymmetry in children, and to determine the roles of maternal objective stress exposure, subjective stress reaction, and postdisaster cortisol. Ridge counts for homologous fingers were scored for 77 children (20 target exposed [Weeks 14-22] and 57 nontarget exposed [exposed during other gestation weeks]). Children in the target group had more than 0.50 SD greater asymmetry than the nontarget group. Within the target group, children whose mothers had high subjective ice storm stress had significantly greater asymmetry than those with lower stress mothers, and maternal postdisaster cortisol had a significant negative correlation with the children's dermatoglyphic asymmetry (r = -.56). Prenatal maternal stress during the period of fingerprint development results in greater dermatoglyphic asymmetry in their children, especially in the face of greater maternal distress. [ABSTRACT FROM AUTHOR]

Background: Prenatal maternal stress exposure has been linked to sub-optimal developmental outcomes in toddlers, while maternal emotional availability is associated with better cognitive and language abilities. It is less clear whether early care-giving relationships can moderate the impact of prenatal stress on child development. The current study investigates the impact of stress during pregnancy resulting from the Queensland Floods in 2011 on toddlers' cognitive and language development, and examines how maternal emotional availability is associated with these outcomes.Methods: Data were available from 131 families. Measures of prenatal stress (objective hardship, cognitive appraisal, and three measures of maternal subjective stress) were collected within one year of the 2011 Queensland floods. Maternal emotional availability was rated from video-taped mother-child play sessions at 16 months: sensitivity (e.g., affective connection, responsiveness to signals) and structuring (e.g., scaffolding, guidance, limit-setting). The toddlers' cognitive and language development was assessed at 30 months. Interactions were tested to determine whether maternal emotional availability moderated the relationship between prenatal maternal stress and toddler cognitive and language functioning.Results: Prenatal stress was not correlated with toddlers' cognitive and language development at 30 months. Overall, the higher the maternal structuring and sensitivity, the better the toddlers' cognitive outcomes. However, significant interactions showed that the effects of maternal structuring on toddler language abilities depended on the degree of prenatal maternal subjective stress: when maternal subjective stress was above fairly low levels, the greater the maternal structuring, the higher the child vocabulary level.Conclusion: The current study highlights the importance of maternal emotional availability, especially structuring, for cognitive and language development in young children. Findings suggest that toddlers exposed to higher levels of prenatal maternal stress in utero may benefit from high maternal structuring for their language development. [ABSTRACT FROM AUTHOR]

We determined the extent to which DNA methylation mediates the effects of maternal cognitive appraisal of a natural disaster during pregnancy on offspring growth at age 13. Negative maternal cognitive appraisal predicted both lower BMI and central adiposity via DNA methylation of diabetes-related genes, suggesting a protective role of epigenetics. [ABSTRACT FROM AUTHOR]

Abstract: Prenatal stress might increase cardiometabolic disease risk. We measured prenatal stress due to an ice storm in 1998, and measured glucose tolerance among a subsample of 32 exposed adolescents in 2011. Severity of stress was positively associated with insulin secretion, suggesting that prenatal stress independently predicts metabolic outcomes in adolescence. [Copyright &y& Elsevier]