Stress biomarkers and child development in young children in Bangladesh.

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Butzin-Dozier, Zachary

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Mertens, Andrew N

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Tan, Sophia T

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Granger, Douglas A

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Pitchik, Helen O

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Il'yasova, Dora

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Tofail, Fahmida

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Rahman, Md Ziaur

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Spasojevic, Ivan

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Shalev, Idan

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Ali, Shahjahan

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Karim, Mohammed Rabiul

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Shahriar, Sunny

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Famida, Syeda Luthfa

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Shuman, Gabrielle

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Shoab, Abul K

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Akther, Salma

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Hossen, Md Saheen

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Mutsuddi, Palash

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Rahman, Mahbubur

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Unicomb, Leanne

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Das, Kishor K

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Yan, Liying

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Meyer, Ann

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Stewart, Christine P

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Hubbard, Alan E

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Naved, Ruchira Tabassum

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Parvin, Kausar

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Mamun, Md Mahfuz Al

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Luby, Stephen P

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Colford, John M

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Fernald, Lia CH

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Lin, Audrie

dc.date.accessioned

2024-05-01T13:52:59Z

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2024-05-01T13:52:59Z

dc.date.issued

2024-03

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Background

Hundreds of millions of children in low- and middle-income countries are exposed to chronic stressors, such as poverty, poor sanitation and hygiene, and sub-optimal nutrition. These stressors can have physiological consequences for children and may ultimately have detrimental effects on child development. This study explores associations between biological measures of chronic stress in early life and developmental outcomes in a large cohort of young children living in rural Bangladesh.

Methods

We assessed physiologic measures of stress in the first two years of life using measures of the hypothalamic-pituitary-adrenal (HPA) axis (salivary cortisol and glucocorticoid receptor gene methylation), the sympathetic-adrenal-medullary (SAM) system (salivary alpha-amylase, heart rate, and blood pressure), and oxidative status (F2-isoprostanes). We assessed child development in the first two years of life with the MacArthur-Bates Communicative Development Inventories (CDI), the WHO gross motor milestones, and the Extended Ages and Stages Questionnaire (EASQ). We compared development outcomes of children at the 75th and 25th percentiles of stress biomarker distributions while adjusting for potential confounders using generalized additive models, which are statistical models where the outcome is predicted by a potentially non-linear function of predictor variables.

Results

We analyzed data from 684 children (49% female) at both 14 and 28 months of age; we included an additional 765 children at 28 months of age. We detected a significant relationship between HPA axis activity and child development, where increased HPA axis activity was associated with poor development outcomes. Specifically, we found that cortisol reactivity (coefficient -0.15, 95% CI (-0.29, -0.01)) and post-stressor levels (coefficient -0.12, 95% CI (-0.24, -0.01)) were associated with CDI comprehension score, post-stressor cortisol was associated with combined EASQ score (coefficient -0.22, 95% CI (-0.41, -0.04), and overall glucocorticoid receptor methylation was associated with CDI expression score (coefficient -0.09, 95% CI (-0.17, -0.01)). We did not detect a significant relationship between SAM activity or oxidative status and child development.

Conclusions

Our observations reveal associations between the physiological evidence of stress in the HPA axis with developmental status in early childhood. These findings add to the existing evidence exploring the developmental consequences of early life stress.
dc.identifier

S0306-4530(24)00067-2

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0306-4530

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1873-3360

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https://hdl.handle.net/10161/30658

dc.language

eng

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Elsevier BV

dc.relation.ispartof

Psychoneuroendocrinology

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10.1016/j.psyneuen.2024.107023

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https://creativecommons.org/licenses/by-nc/4.0

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Alpha-amylase

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Child development

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Cortisol

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Stress

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Child

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Humans

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Child, Preschool

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Female

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Male

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Child Development

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Hydrocortisone

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Hypothalamo-Hypophyseal System

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Receptors, Glucocorticoid

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Bangladesh

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Pituitary-Adrenal System

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Biomarkers

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Saliva

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Stress, Psychological

dc.title

Stress biomarkers and child development in young children in Bangladesh.

dc.type

Journal article

pubs.begin-page

107023

pubs.organisational-group

Duke

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School of Medicine

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Clinical Science Departments

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Family Medicine and Community Health

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Family Medicine and Community Health, Prevention Research

pubs.publication-status

Published

pubs.volume

164

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