Differential consequences of obstetric complications and childhood maltreatment on neurodevelopmental, emotional and behavioral outcomes in children and adolescents: exploring sex differences
N. San Martín-González, L. Marqués-Feixa, S. Romero, J. March-Llanes, M. Rapado-Castro, I. Zorrilla, H. Blasco-Fontecilla, S. Papiol, L. FañanásIntroduction
Early-life adversity, including pre/perinatal stress and childhood maltreatment (CM), is strongly linked to neurodevelopmental and psychiatric outcomes. However, the specific impact of these stressors and the differential effects in males and females remain poorly understood.
Objectives
This study aims to investigate the relative and combined impact of maternal psychosocial stress during pregnancy, obstetric complications (OC), and CM on neurodevelopmental delays, emotional/behavioral symptoms, and DSM-5 diagnoses before puberty (12 y.o.), with a focus on sex differences.
Methods
211 participants aged 7–17 from the Spanish multicenter Epi_Young_Stress study were included (130 with psychiatric diagnoses and 81 controls). 26.06% of children presented a psychiatric diagnosis and 25.1% a neurodevelopmental disorder before puberty. Hierarchical and logistic regression models were used. Neurodevelopmental subdomains, CBCL dimensions, overall adjustment (CGAS), and DSM-5 diagnoses were the studied outcomes. Predictor variables included socioeconomic status, maternal distress during pregnancy, OC, CM, and IQ. Interaction effects between prenatal and postnatal stressors were tested.
Results
OC were associated with motor and language neurodevelopmental delays and attentional problems and worst adjustment only in males. CM emerged as the most consistent and robust predictor of emotional/behavioral problems, worst overall adjustment and psychiatric diagnoses in both sexes. Interaction effects between OC and CM were found for language, reading and writing problems in males. Vocabulary IQ emerged as a consistent protective factor.
Conclusions
CM is a critical determinant of early psychopathology regardless child’s sex. OC contribute to neurodevelopmental and attentional problems only in males. Findings underscore the need for early identification and sex-specific interventions.
Disclosure of Interest
None Declared