Prenatal Adversity and Neonatal Brain Connectivity Relate to Emerging Executive Function at Age 2 Years

Objective: Early life adversity alters the structure and function of higher-order brain networks that subserve executive function (EF). The extent that prenatal exposure to adversity and neonatal white matter (WM) microstructure and resting-state functional connectivity (rs-fc) underlie problems in emerging EF remains unclear. Method: This prospective study includes 164 infants (45% female, 85% term-born) who were recruited prenatally and underwent neonatal diffusion and rs-fc magnetic resonance imaging scans. Social disadvantage and maternal psychosocial stress were assessed in the prenatal period. At age 2 years, children completed the Minnesota Executive Function Scale. Multivariable regression, moderation, and mediation analyses examined associations between prenatal adversity, neonatal WM microstructure and rs-fc, and emerging EF outcome. Results: Prenatal social disadvantage (PSD), but not maternal psychosocial stress, was associated with poorer emerging EF. After multiple comparison correction, higher mean diffusivity (MD) and lower fractional anisotropy (FA) in the corpus callosum, as well as higher MD in the inferior fronto-occipital fasciculus and corticospinal tract and lower FA in the uncinate, related to poorer emerging EF. In moderation analysis, associations between neonatal WM microstructure and emerging EF did not vary as a function of PSD. In mediation analyses, neonatal WM microstructure did not attenuate the association between PSD and emerging EF. The rs-fc findings did not pass multiple comparison correction. Conclusion: PSD was related to poorer emerging EF outcomes. Neonatal WM microstructure was also related to emerging EF, with similar associations for children with lower or higher PSD. Prenatal social welfare programs may support neonatal brain development and early neurodevelopmental outcomes. Plain language summary: Prenatal exposure to social disadvantage is related to early alterations in neonatal brain structure and function. This study sought to understand the implications of these relationships for the early emergence of executive function (EF). In a sample of 164 infants, this longitudinal study found that prenatal exposure to social disadvantage and less-developed neonatal brain pathways were key risk factors associated with problems in emerging EF at age 2 years. These associations persisted after accounting for maternal and child general cognitive ability. Findings provide insight into the mechanisms of early EF development and suggest that addressing family socioeconomic hardships early in life may support infant neurodevelopment. Diversity & Inclusion Statement: We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way.