Abstract
Background
Early life stress has enduring effects on physical and mental health. Hair cortisol concentrations (HCCs) reflect exposures to contextual stressors in early life, but are understudied in preschool children.
Methods
Hair samples from children (N = 693) during clinic visits (CVs) scheduled at 1–4 years (CV1–CV4) were measured using validated assay methods for HCC.
Results
HCCs were highest at CV1 and decreased at CV2–CV4, with no sex differences. Black children had higher HCC than White/other children; these differences persisted even after adjusting for socioeconomic factors. Bivariable analyses showed significant effects on HCC for Black race, with specific demographic and psychosocial factors at different ages. Multivariable analyses showed that higher HCC at CV1 were associated with Black race and male sex; at CV2 with Black race, lower maternal self-esteem, socioeconomic adversity, and the child’s risk for developmental delay; at CV3 with Black race; at CV4 with maternal depression and the child’s prior HCC values.
Conclusions
HCCs were higher in Black children than White/other races; differences were related to maternal factors, socioeconomic adversity, and the child’s risk for developmental delay. Public health measures to reduce disparities between Blacks and other races must also consider the long-term effects of chronic stress in early life.
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Acknowledgements
Grant Somes, Ph.D. (University of Tennessee Health Science Center [UTHSC]) conceived of the CANDLE study and obtained initial funding. We gratefully acknowledge the participants, particularly the mothers who consented to participate in the CANDLE study; the cognitive examiners from the UTHSC Boling Center for Developmental Disabilities: Sacha Bliss, Ph.D., Lauren Gardner, Ph.D., Bruce Keisling, Ph.D., Cynthia Klubnik, Ph.D., Kerrie Murphy, Ph.D., Jessica Myszak, Ph.D., Nichol Pritchard, Ph.D., Colby Reed, Ph.D., Christina Warner-Metzger, Ph.D.; and other individuals from UTHSC who participated in the design and execution of the study: Phyllis Richey, Ph.D., Wonsuk Yoo, Ph.D., D. Pamela Connor, Ph.D., Marion Hare, M.D., M.S., and Anand Kulkarni, M.D.; Karmen McPherson and Aaron Kala (UTHSC medical students) for helping with hair cortisol analyses performed in the Pain/Stress Neurobiology Laboratory at the University of Tennessee Neuroscience Institute; data collection, processing and editing by the CANDLE staff; Amy Scheck, M.S., CANDLE science coordinator and Maureen Sorrells, MPH CANDLE study coordinator at UTHSC. We also acknowledge helpful comments from Drs. Nicole Bush, Ph.D. (UCSF), Kaja LeWinn, Sc.D. (UCSF) and Robert Davis, M.D., MPH (UTHSC) on earlier drafts of this manuscript. Grants from The Urban Child Institute to the University of Tennessee Department of Preventive Medicine supported the CANDLE study (Principal Investigator (P.I.) Tylavsky). The current studies received funding from the Maternal & Child Health Research Institute at Stanford University (P.I. Anand), NIH/National Institute for Drug Abuse (R41 DA046983, P.I. Anand), NIH/Eunice Kennedy Shriver National Institute for Child Health & Human Development (R01 HD099296, P.I. Anand; R21 HD090493, P.I. Gotlib); NIH/National Institute of Mental Health (R37 MH101495, P.I. Gotlib), and the Oxnard Foundation to UTHSC (P.I. Anand). Study sponsors had no role in the design and conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, approval, or decision to publish this manuscript. Authors received no honoraria, grants, or other payments for writing this manuscript.
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K.J.S.A. provided the concept and study design, obtained funding, designed data analysis and data interpretation, initially drafted the article, made critical revisions of the article, and approved the final version to be published; C.R.R. contributed to research design, sample analyses, data analysis and interpretation, critical revisions of the article, and approved the final version to be published; J.R. performed all data analyses and interpretation, drafted and critically revised the article, and approved the final version to be published; F.F.Q. and S.T. contributed to data analysis and interpretation, critical revisions of the article, and approved the final version to be published; L.E.M., D.A.B., and I.H.G. helped with data interpretation, critical revisions of the article, and approved the final version to be published; and F.A.T. contributed to conception and study design, research regulatory compliance, data collection, critical revisions of the article, and approved the final version to be published.
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Anand, K.J.S., Rovnaghi, C.R., Rigdon, J. et al. Demographic and psychosocial factors associated with hair cortisol concentrations in preschool children. Pediatr Res 87, 1119–1127 (2020). https://doi.org/10.1038/s41390-019-0691-2
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DOI: https://doi.org/10.1038/s41390-019-0691-2
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