The contribution of childhood adversity to cortisol measures of early life stress amongst infants in rural India: Findings from the early life stress sub-study of the SPRING cluster randomised controlled trial (SPRING-ELS)

PSYCHONEUROENDOCRINOLOGY

卷:107

Article

Bhopal, Sunil¹  Verma, Deepali²  Roy, Reetabrata¹  Soremekun, Seyi¹  Kumar, Divya²  Bristow, Matt³  Bhanushali, Aparna⁴  Divan, Gauri²  Kirkwood, Betty¹ 

[1] London Sch Hyg & Trop Med, Fac Epidemiol & Populat Hlth, Dept Populat Hlth, Maternal & Child Hlth Intervent Res Grp, London, England

[2] Sangath, New Delhi, India

[3] Anglia Ruskin Univ, Sch Psychol & Sports Sci, Cambridge, England

[4] SRL Labs Ltd, Res & Dev Div, Mumbai, Maharashtra, India

关键词: Infant;    Child;    Adversity;    Adverse childhood experiences;    Stress;    HPA axis;    Cortisol;   

DOI  :  10.1016/j.psyneuen.2019.05.012

来源: Elsevier

【 摘 要 】

Background: The majority of the world's children live in low- and middle-income countries and face multiple obstacles to optimal wellbeing. The mechanisms by which adversities social, cultural, psychological, environmental, economic - get 'under the skin' in the early days of life and become biologically embedded remain an important line of enquiry. We therefore examined the contribution of childhood adversity through pregnancy and the first year of life to hair and salivary cortisol measures of early life stress in the India SPRING home visits cluster RCT which aims to improve early childhood development. Methods: We assessed 22 adversities across four domains: socioeconomic, maternal stress, family-child relationship, and child and summed them to make a cumulative adversity score & quintiles, and four subscale scores. We cut 3 cm of hair from the posterior vertex and took three saliva samples from morning till late afternoon on each of two days (total six samples). We analysed both for cortisol concentration using ELISA techniques. We used multiple linear regression techniques to assess the relationship between cumulative adversity and log hair cortisol concentration and saliva diurnal slope and area under the curve. Results: We assessed 712 children for hair, and 752 children for saliva cortisol at 12 months of age. We found a strong positive relationship between adversity and hair cortisol; each additional adversity factor was associated with hair cortisol increases of 6.1% (95% CI 2.8, 9.4, p < 0.001) and the increase from adversity quintile one to five was 59.4%. Socioeconomic, relationship and child scales were independent predictors of hair cortisol (socioeconomic 6.4% (95% CI -0.4, 13.6); relationship 11.8% (95% CI 1.4, 23.2); child 7.9% (95% CI -0.5, 16.9). We did not find any association between any measures of adversity and either of the saliva cortisol outcomes. Discussion: This is the largest study of hair cortisol in young children, and the first in a low- and middle-income country setting. Whilst the short-term diurnal measures of cortisol did not appear to be linked with adversity, chronic exposure over several months appears to be strongly associated with cumulative adversity. These findings should spur further work to understand the specific ways in which adversity becomes biologically embedded, and how this can be tackled. They also lend support to ongoing action to tackle childhood adversity in communities around the world.

【 授权许可】

Free