Behavioral moderators of In-utero superstorm sandy exposure and fronto-limbic cortical development—potential role of adaptiveness in clinical intervention strategies, a pilot study

Introduction: Prenatal maternal stress may predispose a child to alterations in neurodevelopment and future psychopathology. Meanwhile, environmental disasters related to climate change are increasing in severity with significant impacts on physical and mental health. The current study explores the relationships among child behaviors, brain morphometry, and weather-related in-utero stress during Superstorm Sandy (SS). Methods: Parents completed the Behavioral Assessment System for Children, Second Edition (BASC-2) to quantify the extent of adaptive and clinical (externalizing/internalizing) behaviors at age 5. Magnetic resonance imaging of 9 SS-exposed and 21 non-exposed children at age 8 was used to assess brain volume. We analyzed main effects of in-utero SS exposure on brain volume/behavior and mediation-moderation models of exposure, behaviors and brain volume to determine how the association between exposure and brain volume is influenced by early childhood behavioral phenotypes. Results: The SS-exposed group had significantly greater externalizing behavioral problems, bilateral amygdala enlargement, and volumetric reduction of the left medial orbitofrontal cortex. While no behavioral phenotype mediated the association of exposure with brain volume, adaptive behaviors, as measured by four subdomains of the BASC-2 (social skills, activities in daily life, functional communication, and adaptivity), moderated the adverse impact of in-utero stress on brain volume later in life. Discussion: These findings highlight the importance of evaluating the interactive relationships among in-utero stress, behaviors, and neural development of the child to facilitate early identification and intervention for more vulnerable children. Promoting adaptive behaviors in early childhood may minimize the deleterious impact of prenatal stress exposure on subsequent brain development.