IJE Advance Access published online on May 7, 2009
International Journal of Epidemiology, doi:10.1093/ije/dyp200
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Elevated maternal cortisol levels during pregnancy are associated with reduced childhood IQ
1 Center for Health and Community, University of California, San Francisco, California, USA.
2 School of Public Health, University of California, Berkeley, California, USA
3 Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
4 Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA.
5 Department of Community Health, Brown University, Providence, Rhode Island, USA.
* Corresponding author. Center for Health and Community, University of California, San Francisco, 3333 California Street Suite 465, San Francisco, CA 94118, USA. E-mail: lewinnk{at}chc.ucsf.edu
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Abstract |
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Background In animal models, there is evidence to suggest a causal link between maternal cortisol levels during pregnancy and offspring outcomes; however, evidence for this relationship in humans is inconclusive. We address important confounders of this association by estimating the relationship between maternal cortisol levels in late pregnancy and childhood IQ in a birth cohort and in a subsample of siblings.
Methods This study included 832 children who were members of the Collaborative Perinatal Project. Maternal serum collected between 1959 and 1966 during the third trimester of pregnancy was analysed for free cortisol. We investigated the relationship between maternal cortisol in quintiles and full, verbal and performance scale scores on the Wechsler Intelligence Scale for Children at age 7 years, adjusting for prenatal and family characteristics. We repeated this analysis among 74 discordant sibling pairs using a fixed effects approach, which adjusts for shared family characteristics.
Results Maternal cortisol levels were negatively related to full-scale IQ, an effect driven by verbal IQ scores. Compared with those in the lowest quintile of cortisol exposure, the verbal IQ of children in the highest quintile of exposure was 3.83 points lower [95% confidence interval (CI): –6.44 to –1.22]. Within sibling pairs, being in the highest quintile of exposure was associated with verbal IQ scores 5.5 points lower (95% CI: –11.24 to 0.31) compared with the other quintiles.
Conclusion These findings are consistent with prior human and animal studies, and suggest that exposure to high levels of maternal cortisol during pregnancy may be negatively related to offspring cognitive skills independently of family attributes that characterize the postnatal environment.
Keywords Child IQ, prenatal programming, cognitive development, pregnancy, stress, cortisol
Accepted 31 March 2009