Prenatal Stress and Child Development in Low-Middle Income Countries: Linking Maternal Hair Cortisol to Childhood Mental Health and Behavioural Outcomes

Research has shown the importance of prenatal influences on child development, identifying it as a critical window of development; however, less is known about how the mother's chronic physiological stress impacts children’s longer term developmental outcomes. While studies within high-income countries have indicated negative impacts of maternal stress on the development and wellbeing of offspring due to extreme stressors during pregnancy, the impacts of chronic physiological stress remain to be clarified. Recent methodological advances in the use of hair cortisol as a biomarker of stress now make it possible to unobtrusively obtain objective biomarkers of chronic stress at scale in prenatal samples. The current study aims to leverage this possibility to further understanding of the effects of prenatal stress on child developmental outcomes by linking maternal stress, through reported stress alongside hair cortisol concentrations and their ratio to cortisone, with early childhood outcomes. Having data from birth, and at 3-6 and 18 months will allow us to examine the correlations between hair cortisol and its ratio with cortisone during pregnancy and early child development. We will examine the raw associations, associations adjusted for potential confounders, and associations adjusted for other covariates which have been shown to impact child development, to illuminate the unique effects of prenatal physiological stress exposure.