Maternal Stress Hormones and Gestational Hyperglycemia as Predictors of Infant Neurodevelopment

Abstract

Background: Maternal stress hormones and gestational hyperglycemia are increasingly recognized as important prenatal factors that influence fetal programming and infant neurodevelopment. Their combined effect on early developmental outcomes remains insufficiently investigated, particularly in South Asian populations.

Objective: To evaluate maternal stress hormones and gestational hyperglycemia as predictors of infant neurodevelopmental outcomes.

Methodology: This cross-sectional analytical study was conducted from May 2025 to January 2026 at a tertiary care teaching hospital. A total of 120 pregnant women aged 20–40 years with singleton pregnancies were enrolled, including 60 women with gestational hyperglycemia and 60 normoglycemic controls. Maternal serum cortisol concentrations were measured using enzyme-linked immunosorbent assay (ELISA), while gestational hyperglycemia was diagnosed using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria based on a 75-g oral glucose tolerance test. Infant neurodevelopment was assessed at six months using the Ages and Stages Questionnaire, Third Edition (ASQ-3). Independent sample t-tests, chi-square tests, Pearson correlation, and multiple linear regression analyses were performed using SPSS version 26, with p<0.05 considered statistically significant.

Results: Women with gestational hyperglycemia had significantly higher serum cortisol concentrations than normoglycemic controls (24.8 ± 5.1 vs. 18.6 ± 4.3 µg/dL; p<0.001). Infants born to mothers with gestational hyperglycemia demonstrated significantly lower birth weight (2.89 ± 0.41 vs. 3.17 ± 0.38 kg; p<0.001) and reduced composite neurodevelopmental scores (72.4 ± 8.6 vs. 84.9 ± 7.2; p<0.001). Developmental delay was observed in 31.7% of infants in the gestational hyperglycemia group compared with 11.7% in controls (p=0.007). Maternal serum cortisol (r = −0.48, p<0.001) and fasting blood glucose (r = −0.52, p<0.001) showed significant negative correlations with infant neurodevelopmental scores. Multiple linear regression identified fasting blood glucose (β = −0.39, p<0.001) and serum cortisol (β = −0.34, p<0.001) as independent predictors of infant neurodevelopment, explaining 41.6% of the variance in developmental scores (Adjusted R² = 0.416).

Conclusion: Elevated maternal stress hormones and gestational hyperglycemia were independently associated with impaired infant neurodevelopment. Early identification and effective management of maternal psychological stress and glycemic abnormalities during pregnancy may improve neurodevelopmental outcomes in offspring.