Early-life stress exposure and heart morphology in childhood: a prospective population-based study

Check out the GitHub repository for this paper.

Abstract
Aims: Exposure to psycho-social stressors during early development (i.e. early-life stress, ELS) has been linked to an increased risk of cardiovascular conditions in adulthood. It is still unclear, however, whether early morphological changes to the heart could play a role in the pathophysiology of ELS-related CVD, as suggested by animal studies.
Methods: Our sample consisted of 4225 children from the Generation R Study. Cumulative measures of prenatal (i.e., in utero) and postnatal (i.e., from birth to 10 years) ELS exposure were constructed using repeated parental reports. Cardiac MRI was performed when participants were around 10 years old. Using multiple linear regression, we estimated associations between pre-/postnatal ELS exposure and five cardiac outcomes: left ventricular mass, left and right end-diastolic volumes, and left and right ventricular ejection fraction.
Results: Higher prenatal ELS was not associated with cardiac morphology. Higher postnatal ELS was associated with lower left (β [95%CI] = -0.05 [-0.09, -0.02]; P_FDR = .011) and right end-diastolic volumes (β [95%CI] = -0.06 [-0.10, -0.01]; P_FDR=.020), however further adjustment for prenatal ELS exposure attenuated these associations into non-significance (P_FDR = .052 and = .065, respectively). Exploratory follow-up analyses highlighted that these relationships: a) may be stronger in boys compared to girls, b) may be driven largely by socio-economic disadvantage.
Conclusion: We did not find strong evidence to support our hypothesis that higher ELS exposure (both pre- and postnatally) is associated with altered cardiac morphology already in childhood. Further research is warranted to test whether these relationships may emerge later in development.