Prenatal Risk Factors for Child Executive Function at Ages 3-5: The Impact of Maternal Mood, Substance Use, and Socioeconomic Adversity

Mounting evidence establishes the association between prenatal mood and substance use with the cognitive and behavioral development in children. More research is required to determine the relative impact of these risk variables on children’s executive function (EF) in the setting of socioeconomic adversities. In order to bridge this gap, the researchers of the current study examined how prenatal maternal anxiety and depression, in the setting of socioeconomic adversities and prenatal substance use, affect childhood EF, particularly working memory and inhibitory control. They hypothesized that poorer EF skills in early childhood would be linked to higher mother mood symptoms, higher levels of persistent prenatal drinking and smoking, and lower socioeconomic status.

Data from 334 mother-child dyads were collected during pregnancy and early childhood. Prenatal maternal depression and anxiety were assessed via questionnaires, while alcohol and tobacco use were evaluated through interviews. Children's inhibitory control and working memory were measured using the EF touch battery at ages 3 to 5 years. Linear regression models analyzed the associations between prenatal exposures (tobacco, alcohol, anxiety, and depression) and child executive function, adjusting for gestational age, sex, age at assessment, and maternal factors.

The findings revealed the following:

·       Children of mothers with high trait anxiety scores exhibited lower inhibitory control compared to those whose mothers had no trait anxiety or depression (β = -0.12, 95% CI: -0.22, -0.01).

·       Additionally, children of mothers classified in the moderate to high continuous smoking group demonstrated reduced inhibitory control (β = -0.19, 95% CI: -0.38, -0.01) compared to children of non-smoking mothers.

·       Moreover, lower maternal education and higher household crowding were both linked to diminished inhibitory control.

·       However, no significant associations were found between prenatal maternal depression, anxiety, or socioeconomic factors and working memory.

Thus, these findings highlight the importance of developing comprehensive, context-specific intervention programs that include mental health support for women to foster healthy inhibitory control development in children.

Source: Rayport YK, Morales S, Shuffrey LC, Hockett CW, Ziegler K, Rao S, Fifer WP, Elliott AJ, Sania A. Prenatal risk factors for child executive function at 3-5 years of age: the roles of maternal mood, substance use, and socioeconomic adversity in a prospective cohort study. BMC Pediatr. 2024 Oct 28;24(1):682. doi: 10.1186/s12887-024-05113-2. PMID: 39465362; PMCID: PMC11514844.