Disclosures: Tiemeier reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
September 17, 2020
2 min read

Poor family functioning during pregnancy may alter child’s brain, behavior

Disclosures: Tiemeier reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Maternal-reported poor family functioning during pregnancy may be associated with child brain characteristics that underlie behavioral problems, according to results of a population-based cohort study published in JAMA Psychiatry.

Henning Tiemeier

“Family influences, such as family functioning and conflict, are understudied in neuroscience and biological psychiatry as potential risk factors,” Henning Tiemeier, MD, PhD, professor of social and behavioral science at Harvard T.H. Chan School of Public Health, told Healio Psychiatry. “We know little about the association of family factors with brain development and whether this underlies emotional and behavioral problems.”

Gaps in prior studies related to this association include a varying period of exposure assessment and rare repeat assessment of exposure; a lack of data regarding whether structural brain changes affect the link between adjustment problems and childhood adversities; and an overemphasis on maternal reports of family functioning, which often neglects paternal reports.

In the current study, Tiemeier and colleagues sought to address these gaps by assessing the links between poor family functioning beginning during pregnancy and cortical, white matter and subcortical volumes. Further, they aimed to examine the extent to which specifically hippocampal volume mediates the association between prenatal parental environmental exposures and preadolescent child problem behavior.

The investigators analyzed data of 2,583 children, as well of 2,583 mothers and 1,788 fathers, who were included in the Generation R Study, a multi-ethnic population-based cohort from fetal life onward. Participants were pregnant women living in Rotterdam, the Netherlands, who had an expected delivery date between April 2002 and January 2006. Tiemeier and colleagues repeatedly assessed mother- and father-rated poor family functioning using the General Functioning subscale of the Family Assessment Device.

The researchers’ primary hypothesis was poor prenatal family functioning was likely associated with smaller amygdala and hippocampal volumes in late childhood. They collected high-resolution structural neuroimaging data of children aged 10 years using a single 3-T MRI system and assessed child emotional and behavioral problems using the Child Behavior Checklist.

Results showed smaller preadolescent hippocampal and occipital lobe volumes among children exposed to prenatal maternal-reported poor family functioning. However, the researchers observed no evidence for a link between poor family functioning exposure during mid- or late childhood and brain morphology. After adjusting for prior child problems at age 1.5 years, the association between preadolescent problem behavior and prenatal maternal-reported poor family functioning appeared partially mediated by hippocampal volumes. Upon analyzing combined maternal and paternal functioning ratings, the researchers noted similar results; however, maternal family functioning reports largely drove associations.

“It is well known that poor family functioning is an important risk factor for child psychiatric disorders,” Tiemeier said. “It is also known that interventions aimed at altering poor family functioning or its consequences can be successful. This study suggests that the fetal and infant brain may be vulnerable to poor family functioning, such as conflict, and serves as a powerful reminder that clinicians need to address family factors and, where necessary, intervene or refer to specialists.”