#69 - Pregnancy and postpartum maternal hair cortisol are associated with infant development during the COVID-19 pandemic

Background Research demonstrates elevated levels of distress for perinatal women during the COVID-19 pandemic. It remains unclear how the pandemic impacts maternal hypothalamic- pituitary-adrenal (HPA) axis activity and whether HPA activation is associated with infant development. The current study examined how maternal hair cortisol in the perinatal period was associated with infant developmental outcomes during the COVID-19 pandemic. Methods This longitudinal study followed 158 mother-infant dyads during pregnancy, 6 weeks, and 6 months postpartum. During pregnancy and 6-weeks postpartum, hair cortisol concentrations (HCC) were extracted from mother’s hair to index cortisol levels over the prior 3 months. A latent variable of infant development at 6 months was derived from Ages and Stages Questionnaire (ASQ) subscales, including communication, motor, problem solving, and social/personality development. Structural equation regression models were conducted using MPLUS to examine the main effects and interaction between pregnancy and postpartum HCC on infant development. Results After controlling for infant sex, birthweight and age, lower maternal HCC in pregnancy was associated with lower ASQ scores (B =0.249, SE=0.099, CI[0.054, 0.443]); there was no main effect of HCC at 6-weeks postpartum. There was a significant interaction between pregnancy and postpartum HCC (B=0.713, SE=0.221, CI[0.279, 1.147]), such that mothers with lower HCC in pregnancy and higher HCC 6-weeks postpartum had infants with lower ASQ scores. Conclusion A transition from blunted to elevated HPA activity over the perinatal period adversely impacts infant development. Findings underscore the importance of perinatal HPA activation for child development during the COVID-19 pandemic.