Preconception and Prenatal Stress: Pathways to Child Biology and Behavior (2012-2019)

Funded by NICHD
PI: Chris Dunkel Schetter, PhD 
CoPIs: Sharon Ramey, PhD, Virginia Tech Carilion Research Institute and Virginia Tech

Madeleine Shalowitz, MD, MBA, North Shore University Health System

Elysia Poggi Davis, PhD, University of Colorado, Denver

Project Coordinator: Christine Guardino, PhD, University of California, Los Angeles


This study is a follow-up to the large, multi-site NIH collaborative Community Child Health Network (CCHN) study of a larger cohort of mothers and their partners or fathers of their children (see below for CCHN Study Design). The new study focuses on HPA axis regulatory mechanisms in a sample of 100-200 ethnically/racially diverse mother-child pairs,                    particularly the prediction of child cognitive and health outcomes at ages 3-4 and 4-5, as well as diurnal cortisol and cellular aging (indexed by telomere length) in both young            children and their mothers. The parent study includes extensive interview measures of          maternal stress and biomarkers before conception and during pregnancy, creating a unique opportunity to examine prospective predictors of child outcomes.

Participants are recruited from an enrolled cohort of mostly low-income women in three study sites:  eastern North Carolina, Washington, DC, and Lake County, IL near Chicago. Pairs of trained researchers visit participants’ homes to conduct interviews, collect                  biomarkers, and administer child assessments when children are approximately 3.5 and 4.5 years of age.  The first study visit (at 3.5 years) includes an extensive maternal interview, biomarker collection, administration of the Differential Ability Scales (DAS) to children, and a videotaped mother-child interaction task.  The second study visit (at 4.5 years) includes a maternal interview, biomarker collection, and assessment of child cognitive function using the NIH Toolbox Early Childhood Cognition Battery.

The specific aims are to examine effects of maternal stress and allostatic load, especially HPA regulation during preconception and in pregnancy on outcomes at ages 3.5 and 4.5. The outcomes are: (1) children’s circadian regulation of cortisol production; (2) children’s fearful or anxious temperament measured by maternal observation; (3) children’s                    neurocognitive functioning using standardized assessments; (4) children’s buccal cell telomere length at age 3.5 and rates of shortening from ages 3.5 to 4.5. We will also                  examine buccal cell telomere length of mothers as a function of stress and test for mother-child associations.

Selected Publications

Morgan, J. E., Lee, S. S., Mahrer, N. E., Guardino, C. M., Poggi Davis, E., Shalowitz, M. U., Ramey, S. L., & Dunkel Schetter, C. (2020). Prenatal maternal  C-reactive protein.                  prospectively predicts child executive functioning at ages 4-6 years. Developmental              Psychobiology, 62(2), 1111-1123. View file:

Mahrer, E., Guardino, C., Hobel, C. & Dunkel Schetter, C. (2020). Maternal stress before.      conception is associated with shorter gestation. Annals of Behavioral  Medicine, 20, 1-11. 10.1093/abm/kaaa047 View file:

Alen, N. V., Hostinar, C. E., Mahrer, N. E., Martin, S. R., Guardino, C., Shalowitz, M. U., Ramey, S.L., Dunkel Schetter, C. (2020). Prenatal maternal stress and child  hair  cortisol four years later: Evidence from a low-income sample.  Psychoneuroendocrinology 117.          Article 104707. View file:

Carroll, J. E., Mahrer, N. E., Shalowitz, M., Ramey, S., & Dunkel Schetter, C. (2020). Prenatal maternal stress prospectively relates to shorter child buccal cell telomere length.                  Psychoneuroendocrinology, 121, 104841. View file:

Mahrer, N. E., Ramos, I. F., Guardino, C., Davis, E. P., Ramey, S. L., Shalowitz, M. U., &  Dunkel Schetter, C. (2020 ). Pregnancy anxiety in expectant mothers predicts offspring            negative affect: The moderating role of acculturation. Early Human Development, 141, 104932. View file: