Feasibility study of prospective follow-up of neurodevelopmental outcomes in pregnancies identified as high stress at 20 weeks gestation in a disadvantaged community

Introduction The impacts and mechanisms of environmental factors, such as prenatal stress, on neurodevelopment are poorly understood. Our lab previously characterized maternal miRNA changes related to prenatal stress exposure and its association with autism spectrum disorder (ASD) and subsequently examined miRNA from saliva samples associated with stress during pregnancy. Eighty-three pregnant Black women (ages 18–40) at the time of their 20-week ultrasound were assessed for stress markers by stress survey questionnaires. miRNA analysis was performed on the 10 highest- and 10 lowest-stress subjects. Thirty-four miRNA had significant differential expression, with 5 being upregulated and 29 downregulated in the high-stress group. Predicted targets revealed significant enrichment in neurodevelopmental pathways, including forebrain development, sensory system development, and neuronal growth regulation. Methods In the present study, we assessed developmental outcomes of the children from a the top tertile of this cohort for stress exposure based on surveys assessing general developmental progress, language development, and autism spectrum disorder screenings. Results Fifteen of this top tertile (27 individuals) had agreed to further contact and provided contact information, and eight of these individuals responded to the outcome queries. This study supported the feasibility of follow-up in this setting. Additionally, we found that a majority of the children from the high stress category pregnancies took longer to develop language milestones, showed behaviors of concern, and even reported a diagnosis of autism after follow-up. Discussion This provides further support for the interrelationship between stress exposure during pregnancy and neurodevelopmental outcomes and the feasibility of follow-up after pregnancy for this type of study in disadvantaged communities.