700 - Maternal Pregnancy Stress and Behavioral Adjustment at 36 Months in Children of the Pediatric Outcomes of Prenatal Zika Exposure Cohort

Toxic stress during pregnancy can lead to poor pregnancy outcomes and transmission of dysregulated stress responses to the offspring with long-term consequences on the child’s physical health and development. Social determinants of health can increase pregnant women and child vulnerability to stress. The 2015-18 Zika epidemic was a population-wide adversity of serious maternal-child consequences. Exposed children without evident birth defects are at risk for developmental impairment. As they approach learning readiness, critical questions remain on the impact of prenatal stress on child behavior, and if resilience can be protective.

Objective:

The Pediatric Outcomes of Prenatal Zika Exposure (POPZE) study aims to characterize the spectrum of disease from birth to learning readiness, and to identify the environmental correlates of ZIKV consequences.

Design/Methods:

Fifty-three mothers of 55 children from the POPZE study completed the Child Adjustment and Parent Efficacy Scale (CAPES), the Maternal Resilience Scale (ERESMA) and the Prenatal Stress Scale (PSS) to assess child behavioral and emotional difficulties and parental self-efficacy in managing child behavior, maternal resilience, and prenatal stress. We examined associations between maternal socioemotional characteristics and child adjustment outcomes through linear regression analysis adjusted by child sex, gestational age, and maternal education.

 

Results: Mothers had a mean age of 30 years; 23% had low education attainment (high school or less). Child’s mean age was 36.6 months; 56% were female. The mean PSS score was 31.1 (12.2) and 53% endorsed at least 10/18 stressors. Maternal resilience achieved a high mean score at 211.2 (13.1). CAPES behavior, emotional maladjustment, and self-efficacy mean scores were 17.3 (9.4), 1.64 (2.1), and 169.0 (27.3), respectively. In adjusted regression models, children of mothers with higher prenatal stress presented more behavioral difficulties (B=0.32, SE=0.10, p=0.002) than their counterparts. Those born to mothers with higher resilience had less behavioral (B=-0.27, SE=0.10, p=0.007) and emotional (B=-0.09, SE=0.02, p< 0.0001) difficulties. Mothers with higher resilience had higher self-efficacy in managing behavior than those with lower resilience.

Conclusion(s): In this study heightened prenatal stress was linked to behavioral characteristics of exposed children at 36 months. Maternal resilience influence can be seen in less child behavioral and emotional difficulties and higher self-efficacy in managing misbehavior. These results can inform family and public health approaches to learning readiness.