Maternal Prenatal Stress and Later Child Behavioral Problems in an Urban South African Setting
Accepted 16 November 2009. published online 11 February 2010.
Objective
Findings from a number of cohort studies suggest that children who are exposed to maternal stress during pregnancy have an increased risk of behavioral problems. All of the research assessing this association to date has been conducted in developed countries; yet the majority of the child population, and the majority of the burden of psychopathology, exist in developing nations, where different patterns and levels of stressors may exist. The present study set out to examine whether maternal prenatal stress is associated with an increased risk of subsequent child behavioral problems in a developing country.
Method
Participants (n = 953) were from Birth to Twenty, a longitudinal birth cohort study based in Soweto-Johannesburg, South Africa, a socioeconomically disadvantaged urban area. Pregnant women completed questionnaires assessing stressors, and children's behavioral functioning was subsequently assessed when they were aged 2 and 4 years.
Results
Children whose mothers had high levels of prenatal stressors did not have an increased risk of behavioral problems at age 2 years, but they did at 4 years (adjusted odds ratio 2.52 [CI = 1.04, 6.09]). Partner conflict and family adversity were the stressors most strongly associated with adverse child outcome.
Conclusions
These findings highlight the importance of the psychological health of pregnant women in developing countries, both for the mother and her offspring, and the need for greater research in resource-poor settings.
bHuman Sciences Research Council, Durban, South Africa, and holds honorary appointments at the Universities of Oxford and Witwatersrand, Johannesburg, South Africa
Correspondence to: Dr. Ramchandani, University of Oxford Department of Psychiatry, Warneford Hospital, Headington, Oxford OX3 7JX, UK
The Birth to Twenty Research Programme is financially supported by the Wellcome Trust (United Kingdom, grant number 077210), Medical Research Council of South Africa, Human Sciences Research Council of South Africa, and the University of the Witwatersrand, Johannesburg.
Disclosure: Dr. Ramchandani and Dr. Stein are supported by the Wellcome Trust. Drs. Richter and Norris report no biomedical financial interests or potential conflicts of interest.
ABSTRACT