The Moderating Effect of Parenting on the Relationship Between COVID -19 Prenatal Maternal Stress and Child Internalising Behaviours: The Birth in the Time of COVID (BITTOC) Study

Abstract

The in utero and early post-natal environment has long-lasting implications for development. This is demonstrated by the multitude of poorer child outcomes associated with prenatal maternal stress (PNMS), such as child internalising behaviours. Positive parenting behaviours have been shown to ameliorate such associations. Conversely, negative parenting behaviours can lead to poorer child outcomes. No study has yet examined the relationship between PNMS and child internalising behaviours, nor the influence of parenting on this relationship, in the context of the COVID-19 pandemic.

This study examines whether supportive and unsupportive parenting behaviours attenuate the relationship between PNMS and child internalising behaviours, in a cohort of Australian women pregnant during the COVID-19 pandemic (n = 1219). Recruitment began on 20 March 2020, with eligible participants required to be English-speaking, be over 18 years in age, be pregnant with a singleton, have access to the internet, and be living in Australia. At recruitment, women reported on their COVID pandemic-related PNMS (objective hardship, cognitive appraisal, subjective distress), maternal age at time of birth, child sex, level of maternal education, relationship status, Aboriginal or Torres Strait Islander status, the state in which they lived, and language spoken at home. Parenting behaviour, maternal mood and child internalising behaviours were reported by mothers at 24 months post-partum. Hierarchical multiple regressions were conducted to examine the association between PNMS and child internalising behaviours as well as the moderating effects of parenting.

Results showed that COVID-19 pandemic-related PNMS did not predict child internalising behaviours. This study found maternal mood at 24 months was related to concurrent child internalising behaviours, above and beyond COVID-19 pandemic-related PNMS. Moreover, supportive parenting did not moderate the association between PNMS and child internalising behaviours. Unsupportive parenting did not moderate the relationship between maternal objective hardship or maternal subjective distress and child internalising behaviours at 24 months. There was a significant interaction between maternal cognitive appraisal and unsupportive parenting in relation to child internalizing behaviours at 24 months. Less unsupportive parenting was, however, associated with fewer child internalising behaviours amongst children whose mothers negatively appraised the COVID-19. When mothers had neutral or positive appraisals of the COVID-19 pandemic, unsupportive parenting was not related to child internalising behaviours. Findings indicate that maternal concurrent mood, but not exposure to pandemic-related PNMS is directly related to child internalising behaviours at 24 months of age. Moreover, less unsupportive parenting was associated with fewer child internalising behaviours when mothers perceived their coping ability to be insufficient to overcome the stressors of the COVID-19 pandemic. Findings support the vantage sensitivity hypothesis, such that exposure to a negative cognitive appraisal may render children more susceptible to a positive parenting environment. These children subsequently display fewer problem behaviours in the face of less negative, more positive parenting.