Exposure to prenatal life events stress is associated with masculinized play behavior in girls

Emily S. Barrett, J. Bruce Redmon, Christina Wang, Amy Sparks, Shanna H. Swan

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Previous research has shown that prenatal exposure to endocrine-disrupting chemicals can alter children's neurodevelopment, including sex-typed behavior, and that it can do so in different ways in males and females. Non-chemical exposures, including psychosocial stress, may disrupt the prenatal hormonal milieu as well. To date, only one published study has prospectively examined the relationship between exposure to prenatal stress and gender-specific play behavior during childhood, finding masculinized play behavior in girls who experienced high prenatal life events stress, but no associations in boys. Here we examine this question in a second prospective cohort from the Study for Future Families. Pregnant women completed questionnaires on stressful life events during pregnancy, and those who reported one or more events were considered "stressed". Families were recontacted several years later (mean age of index child: 4.9 years), and mothers completed a questionnaire including the validated Preschool Activities Inventory (PSAI), which measures sexually dimorphic play behavior. In sex-stratified analyses, after adjusting for child's age, parental attitudes toward gender-atypical play, age and sex of siblings, and other relevant covariates, girls (n=72) exposed to prenatal life events stress had higher scores on the PSAI masculine sub-scale (β=3.48, p=0.006) and showed a trend toward higher (more masculine) composite scores (β=2.63, p=0.08). By contrast, in males (n=74), there was a trend toward an association between prenatal stress and higher PSAI feminine sub-scale scores (β=2.23, p=0.10), but no association with masculine or composite scores. These data confirm previous findings in humans and animal models suggesting that prenatal stress is a non-chemical endocrine disruptor that may have androgenic effects on female fetuses and anti-androgenic effects on male fetuses.

Original languageEnglish (US)
Pages (from-to)20-27
Number of pages8
StatePublished - Mar 2014

Bibliographical note

Funding Information:
We wish to acknowledge the SFF study team and the families who participated in the study. In addition, we thank Dr. Sally Thurston for statistical advice. Funding for SFF was provided by the following grants from the National Institutes of Health and the Environmental Protection Agency: Environmental Health Sciences Center Grant ES01247 , R21ES015509 , R01ES09916 , M01-RR00400 , M01RR0425 , and UL1TR000124 . It was also supported by grant 18018278 from the State of Iowa to the University of Iowa. Funding for the current analyses was provided by K12 ES019852-01 and supported by P30 ES001247.

Funding Information:
Dr. Barrett reports grants from National Institutes of Health, during the conduct of the study. Dr. Wang reports grants from Clarus Therapeutics, personal fees and non-financial support from Lilly, grants and personal fees from Besins Health Care International, outside the submitted work. Dr. Sparks reports grants from University of Rochester, during the conduct of the study. Dr. Swan and Dr. Redmon have nothing to disclose.


  • Androgens
  • Play behavior
  • Pregnancy
  • Prenatal stress
  • Sex differences
  • Stress


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