Reduced Brain Region Volumes Found Among Children With a Maternally Reported Dysfunctional Family

A computer-generated image of a brain.
The primary hypothesis, formulated after data collection but before analysis, was that poor prenatal family functioning would be associated with smaller hippocampal and amygdala volumes in late childhood.

Maternal-reported family dysfunction was correlated with a smaller hippocampus volume among their young children. These findings, from a population-based cohort study, were published in JAMA Psychiatry.

Pregnant women (N=2583) in Rotterdam were invited to participate in this longitudinal study between 2002 and 2006. Family function was assessed by the Family Assessment Device. The children of the participating mothers were assessed by a clinical visit, a questionnaire, by magnetic resonance imaging, and by the Child Behavior Checklist.

The included children were aged mean 10.1 (standard deviation [SD], 0.6) years and 50.9% were girls. The mothers were aged mean 31.1 (SD, 4.7) years and the 1788 participating fathers were aged mean 33.5 (SD, 5.3) years.

A poorly functioning family, as reported by the mother, was associated, before correction, with significantly decreased (P <.001) total brain (β, -26.8; 95% CI, -34.6 to -18.9), cerebral white matter (β, -9.76; 95% CI, -13.3 to -6.20), and total gray matter (β, -16.7; 95% CI, -21.3 to -12.2) volumes among the children.

After correcting for cofactors, poor family function remained significantly associated with decreased hippocampal volume (β, -0.08; 95% CI, -0.13 to -0.02; P =.04). This association had a significant interaction with exposure time, in which children of mothers who repeatedly reported poor function had smaller hippocampal volumes (P =.01).

Children who were exposed to poor family function in utero were associated with smaller occipital lobe volumes (β, -0.70; 95% CI, -1.19 to -0.21), specifically in the lateral occipital lobe (β, -0.47; 95% CI, -0.61 to -0.09; P =.01).

Preadolescent problem behavior was associated with hippocampal size and poor family function at 10 years of age (β, 0.08; 95% CI, 0.03-0.13; P =.001).

No correlations were observed for socioeconomic factors or paternally reported family function on brain morphology.

A limitation of this study was the population-based design, in which the investigators were unable to determine whether differences of brain morphology were caused by some factor of poor family function or whether other causative factors were involved.

The study authors concluded that maternally, not paternally, reported family function was significantly associated with reduced hippocampal and occipital lobe volumes among young children. These children are likely to exhibit behavioral problems during adolescence. These data highlighted the need for interventions in which family dysfunction may be present.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Xerxa Y, Delaney SW, Rescorla LA, et al. Association of poor family functioning from pregnancy onward with preadolescent behavior and subcortical brain development [published online September 16, 2020]. JAMA Psychiatry. doi: 10.1001/jamapsychiatry.2020.2862.