title: Biobehavioral Factors in Child Health Outcomes: The Roles of Maternal Stress, Maternal-Child Engagement, Salivary Cortisol, and Salivary Testosterone.
abstract: BACKGROUND
  Exposure to high levels of maternal stress and ineffective maternal-child engagement (MC-E) may adversely affect child health-related outcomes.
  
  
  OBJECTIVE
  The aim of this study was to examine the impact of maternal stress and MC-E on maternal and child biological responses (salivary cortisol and testosterone) and child health outcome in mother-child dyads of preschool children (3-5.9 years) in a low socioeconomic setting.
  
  
  METHODS
  Observational and biobehavioral data were collected from 50 mother-child dyads in a preschool setting. Assessments included maternal stress with the Perceived Stress Scale, child health outcomes with the Pediatric Quality of Life Inventory, and MC-E with videotaped mother-child interactions and scored with the Keys to Interactive Parenting Scale. Morning and evening saliva samples were collected from mother and child for biological assays.
  
  
  RESULTS
  Maternal stress was negatively correlated with MC-E (r = -.32, p < .05) and child health outcome (r = -.33, p < .05). Lower levels of MC-E predicted higher morning cortisol (p = .02) and higher morning and bedtime testosterone levels in children (p = .03 and p = .04, respectively). Child biological responses did not predict child health outcome.
  
  
  CONCLUSIONS
  Maternal stress and MC-E during mother-child interactions play a significant role in the regulation of child stress physiology and child health outcome. Elevated cortisol and testosterone related to high maternal stress and low MC-E may increase the child's vulnerability to negative health outcomes-if sustained. More biobehavioral research is needed to understand how parent-child interactions affect child development and health outcomes in early childhood.
authors: Licia M. Clowtis, PhD, RN, was Assistant Professor (at the time this research was completed), School of Nursing; Duck-Hee Kang, PhD, RN, is Lee and Joseph D. Jamail Distinguished Professor and Director of the Biosciences Laboratory; Nikhil S. Padhye, PhD, is Research Associate Professor and Biostatistician; and Cathy Rozmus, PhD, RN, is PARTNERS Endowed Professor and Associate Dean, Academic Affairs, School of Nursing, University of Texas Health Science Center at Houston. Michelle S. Barratt, MD, MPH, is Professor and Associate Program Director, School of Medicine, University of Texas Health Science Center at Houston.
authors: Licia M
authors: LM
authors: Clowtis
authors: Duck-Hee
authors: DH
authors: Kang
authors: Nikhil S
authors: NS
authors: Padhye
authors: Cathy
authors: C
authors: Rozmus
authors: Michelle S
authors: MS
authors: Barratt
mesh_terms: D002648:Child; D002657:Child Development / Q000502:physiology*; D000067576:Child Health; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D008297:Male; D009034:Mother-Child Relations; D010913:Pituitary-Adrenal System / Q000502:physiology; D011788:Quality of Life; D013315:Stress, Psychological
chemical_list: D006854:Hydrocortisone