History of childhood maltreatment, prenatal cortisol levels, and executive functioning: A cross-sectional study using data from the Healthy Foundations Study

INTRODUCTION: A history of childhood maltreatment is associated with increased risk of psychological and cognitive difficulties as well as stress dysregulation in adulthood; however, less is known about the impacts during pregnancy. The objectives of this study were to explore the association between a history of childhood maltreatment and 1) prenatal stress and 2) executive functioning among pregnant girls and young women. METHODS: Cross-sectional data from the Healthy Foundations Study, including participants aged 14-24 years were used [n = 254; a sub-study of the British Columbia Healthy Connections Project (BCHCP)]. The BCHCP was a randomized controlled trial of the Nurse-Family Partnership (NFP) program in Canada. The Childhood Trauma Questionnaire was used to measure total cumulative childhood maltreatment, as well as dimensions of threat and deprivation. Chronic stress was measured using prenatal hair cortisol, and executive functioning was measured using two standardized tests. All measures were taken at baseline prior to randomization. Linear regression was used to estimate beta coefficients and 95 % confidence intervals (CIs). RESULTS: A high proportion, approximately 55 %, of participants reported a history of moderate to extreme childhood maltreatment. Total cumulative childhood maltreatment was associated with increased prenatal hair cortisol concentration (b = 0.27; 95 % CI: 0.03-0.51), but not executive functioning (b = 0.02; 95 % CI: -0.07-0.11). No moderation was found by psychological resources or distress (p > 0.05). CONCLUSION: A history of childhood maltreatment was significantly associated with increased prenatal hair cortisol but not executive functioning among this sample of disadvantaged pregnant girls and young women in Canada. Further research is needed to inform efforts to prevent childhood maltreatment and to inform NFP refinements to better address early child adversities.