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Original Investigation
April 8, 2019

Association of Perceived Maternal Stress During the Perinatal Period With Electroencephalography Patterns in 2-Month-Old Infants

Author Affiliations
  • 1Department of Pediatrics, Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts
  • 2Harvard Medical School, Boston, Massachusetts
  • 3Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
  • 4Keck School of Medicine, University of Southern California, Los Angeles
  • 5Department of Pediatrics and Human Development, Michigan State University, East Lansing
  • 6Harvard Graduate School of Education, Cambridge, Massachusetts
JAMA Pediatr. 2019;173(6):561-570. doi:10.1001/jamapediatrics.2019.0492
Key Points

Question  Is caregiver exposure to or perception of stress associated with resting electroencephalography power in 2-month-old infants?

Findings  In this cohort study of electroencephalographic data from 70 infants who were 2 months of age, perceived maternal stress was significantly and negatively associated with infant spectral power in the β and γ frequency bands and with a unique profile identified using latent profile analysis of the electroencephalographic data.

Meaning  The findings suggest that infant electroencephalography can be used as an index of the association between caregiver stress and neurodevelopment and to identify indicators of risk and resilience in very young infants.


Importance  Variation in child responses to adversity creates a clinical challenge to identify children most resilient or susceptible to later risk for disturbances in cognition and health. Advances in establishing scalable biomarkers can lead to early identification and mechanistic understanding of the association of early adversity with neurodevelopment.

Objectives  To examine whether maternal reports of stress are associated with patterns in resting electroencephalography at 2 months of age and whether unique electroencephalographic profiles associated with risk and resiliency factors can be identified.

Design, Setting, and Participants  For this cohort study, a population-based sample of 113 mother-infant dyads was recruited from January 1, 2016, to March 1, 2018, during regularly scheduled pediatric visits before infants were 2 months of age from 2 primary care clinics in Boston, Massachusetts, and Los Angeles, California, that predominantly serve families from low-income backgrounds. Data are reported from a single time point, when infants were aged 2 months, of an ongoing cohort study longitudinally following the mother-infant dyads.

Exposures  Maternal reported exposure to stressful life events and perceived stress.

Main Outcomes and Measures  Spectral power (absolute and relative) in different frequency bands (Δ, θ, low and high α, β, and γ) from infant resting electroencephalography (EEG) and EEG profiles across frequency bands determined by latent profile analysis.

Results  Of 113 enrolled infants, 70 (mean [SD] age, 2.42 [0.37] months; 35 girls [50%]) provided usable EEG data. In multivariable hierarchical linear regressions, maternal perceived stress was significantly and negatively associated with absolute β (β = −0.007; 95% CI, −0.01 to −0.001; semipartial r = −0.25) and γ power (β = −0.008; 95% CI, −0.01 to −0.002; semipartial r = −0.28). Maternal educational level was significantly and positively associated with power in high α, β, and γ bands after adjusting for covariates (high school: γ: β = 0.108; 95% CI, 0.014-0.203; semipartial r = −0.236; associate’s degree or higher: high α: β = 0.133; 95% CI, 0.018-0.248; semipartial r=0.241; β: β = 0.167; 95% CI, 0.055-0.279; semipartial r = 0.309; and γ: β = 0.183; 95% CI, 0.066-0.299; semipartial r = 0.323). Latent profile analysis identified 2 unique profiles for absolute and relative power. Maternal perceived stress (β = 0.13; 95% CI, 0.01-0.25; adjusted odds ratio [AOR], 1.14; 95% CI, 1.01-1.28) and maternal educational level (high school: β = 3.00; 95% CI, 0.35-5.65; AOR, 20.09; 95% CI, 1.42-283.16; associate’s degree or higher: β = 4.12; 95% CI, 1.45-6.79; AOR, 61.56; 95% CI, 4.28-885.01) were each associated with unique profile membership.

Conclusions and Relevance  These findings suggest that unique contributions of caregiver stress and maternal educational level on infant neurodevelopment are detectable at 2 months; EEG might be a promising tool to identify infants most susceptible to parental stress and to reveal mechanisms by which neurodevelopment is associated with adversity. Additional studies validating subgroups across larger cohorts with different stressors and at different ages are required before use at the individual level in clinical settings.