Biobehavioral Factors in Child Health Outcomes: The Roles of Maternal Stress, Maternal–Child Engagement, Salivary Cortisol, and Salivary Testosterone

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Exposure to high levels of maternal stress and ineffective maternal–child engagement (MC-E) may adversely affect child health-related outcomes.


The aim of this study was to examine the impact of maternal stress and MC-E on maternal and child biological responses (salivary cortisol and testosterone) and child health outcome in mother–child dyads of preschool children (3–5.9 years) in a low socioeconomic setting.


Observational and biobehavioral data were collected from 50 mother–child dyads in a preschool setting. Assessments included maternal stress with the Perceived Stress Scale, child health outcomes with the Pediatric Quality of Life Inventory, and MC-E with videotaped mother–child interactions and scored with the Keys to Interactive Parenting Scale. Morning and evening saliva samples were collected from mother and child for biological assays.


Maternal stress was negatively correlated with MC-E (r = −.32, p < .05) and child health outcome (r = −.33, p < .05). Lower levels of MC-E predicted higher morning cortisol (p = .02) and higher morning and bedtime testosterone levels in children (p = .03 and p = .04, respectively). Child biological responses did not predict child health outcome.


Maternal stress and MC-E during mother–child interactions play a significant role in the regulation of child stress physiology and child health outcome. Elevated cortisol and testosterone related to high maternal stress and low MC-E may increase the child's vulnerability to negative health outcomes—if sustained. More biobehavioral research is needed to understand how parent–child interactions affect child development and health outcomes in early childhood.

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