Citation

Bryson MHE, Mensah DF, Goldfeld PS, Price DAM. Acad. Pediatr. 2019; ePub(ePub): ePub.

Affiliation

Murdoch Children's Research Institute, Parkville VIC 3052, AUSTRALIA; Centre for Community Child Health, The Royal Children's Hospital, Parkville VIC 3052, AUSTRALIA; Department of Paediatrics, The University of Melbourne, Parkville VIC 3052, AUSTRALIA. Electronic address: anna.price@mcri.edu.au.

Copyright

(Copyright © 2019, Academic Pediatric Association, Publisher Elsevier Publishing)

DOI

10.1016/j.acap.2019.05.008

PMID

31103881

Abstract

OBJECTIVES: Children exposed to early adversity (e.g. financial hardship, family violence, parent mental health difficulties) are at greater risk of poor health outcomes. Physiological stress is one mechanism thought to explain this pathway. We investigated associations between adversity and young children's health, and whether child stress (measured using hair cortisol) mediated these associations.

METHODS: Cross-sectional study of 3-year-old children whose mothers were recruited during pregnancy for their experience of adversity, through the "right@home" trial. Using counts of 9 sociodemographic and 9 psychosocial indicators of adversity, regression models examined relationships between adversity risk counts, child hair cortisol (potential mediator) and 5 health outcomes: externalizing/internalizing problems, physical/socioemotional wellbeing, and overweight/obesity.

RESULTS: Hair cortisol data were available for 297/500 (59%) participating children. When examined separately, sociodemographic adversity risk was associated with higher externalizing problems, and psychosocial adversity risk was associated with higher externalizing problems and poorer physical/socioemotional wellbeing. When examined together in a single model, psychosocial (but not sociodemographic) adversity was associated with higher externalizing problems (unstandardized mean difference (β)=0.53, p=0.002), and poorer physical wellbeing (β=1.19, p=0.009); higher hair cortisol was associated with higher externalizing problems (β=0.76, p=0.02). There was no evidence that stress (hair cortisol) mediated associations between adversity and health.

CONCLUSIONS: In 3-year-old children, we found no evidence that physiological stress (hair cortisol) mediated associations between adversity risk and children's health. Hair cortisol may be limited as a single measure of stress, or physiological stress may not be a mechanism for explaining the effects of adversity on these young children's health.

Copyright © 2019. Published by Elsevier Inc.

Language: en

Keywords

Hair cortisol; adversity; child; health inequalities; stress