title: Prenatal programming of emotion regulation: neonatal reactivity as a differential susceptibility factor moderating the outcome of prenatal cortisol levels.
abstract: OBJECTIVE
  Hypothalamic-pituitary-adrenal (HPA) activation during pregnancy is linked to dysfunctional behavioral outcomes in the offspring. According to Belsky's differential susceptibility hypothesis, individuals vary regarding their developmental plasticity. Translating the differential susceptibility hypothesis to the field of fetal programming, we hypothesize that infants' temperament, as the constitutionally based reactivity to stimulation, moderates prenatal environmental effects on postnatal emotion regulation.
  
  
  METHODS
  Maternal HPA axis activity and stress-reactivity during pregnancy was estimated, by measuring cortisol concentrations in saliva, collected at 0, 30, 45 and 60 min after awakening and in blood, collected during a laboratory stress test (Trier Social Stress Test), respectively. Newborns reactivity to stimulation was evaluated between postnatal day 10 and 14 using the Neonatal Intensive Care Unit Network Neurobehavioral Scale. Infant's self-quieting-activities, as an indicator of emotion regulation, were evaluated at the age of six months during the still face paradigm.
  
  
  RESULTS
  Maternal cortisol reactivity to stress during pregnancy was associated with infant's emotion regulation at the age of six months. Whereas cortisol levels after awakening in mid and late pregnancy were not associated with emotion regulation. Furthermore, regression analyses revealed that in interaction with neonatal reactivity, both, prenatal maternal HPA activity as well as prenatal maternal HPA reactivity to stress predicted emotion regulation.
  
  
  CONCLUSIONS
  The findings indicate that newborns' reactivity to stimulation is moderating the association between prenatal exposure to maternal glucocorticoids and emotion regulation in infancy. Data suggests that temperamental characteristics of the newborn are a relevant differential susceptibility factor with regard to prenatal effects on emotion regulation.
authors.affiliation: Psychiatric University Clinics of Basel, Department of Child and Adolescent Psychiatry, Switzerland; sesam - Swiss Etiological Study of Adjustment Mental Health, National Centre of Competence in Research, Faculty of Psychology, University of Basel, Switzerland. Electronic address: margarete.bolten@upkbs.ch.
authors.forename: Margarete
authors.initials: M
authors.lastname: Bolten
authors.forename: Irina
authors.initials: I
authors.lastname: Nast
authors.forename: Marta
authors.initials: M
authors.lastname: Skrundz
authors.forename: Christina
authors.initials: C
authors.lastname: Stadler
authors.forename: Dirk H
authors.initials: DH
authors.lastname: Hellhammer
authors.forename: Gunther
authors.initials: G
authors.lastname: Meinlschmidt
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D004644:Emotions; D005260:Female; D047109:Fetal Development; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010913:Pituitary-Adrenal System / Q000378:metabolism; D011247:Pregnancy; D011248:Pregnancy Complications / Q000378:metabolism; D037841:Pregnant People / Q000523:psychology; D011297:Prenatal Exposure Delayed Effects / Q000097:blood*; D012463:Saliva / Q000378:metabolism; D013315:Stress, Psychological / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D006854:Hydrocortisone
keywords: AUC(i); Emotion-regulation; HPA axis; Infancy; NICU Network Neurobehavioral Scale; NNNS; Prenatal stress; Reactivity; Temperament; area under the curve with respect to increase; hypothalamic-pituitary-adrenal axis