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We included cortisol reactivity in infancy, and direct and interactive effects of early\u2010life adversity and parenting behaviors (sensitivity, harshness) from infancy to early school age on adolescent cortisol reactivity profiles in model testing. Participants were 216 families (51% female children; 116 cocaine\u2010exposed) recruited at birth, oversampled for prenatal substance exposure, and assessed from infancy to early adolescence (EA). Majority of participants self\u2010identified as Black (72% mothers, 57.2% adolescents), and caregivers were primarily from low\u2010income families (76%), were single (86%), and had high school or below education (70%) at recruitment. Latent profile analyses identified three cortisol reactivity patterns including elevated (20.4%), moderate (63.1%), and blunted (16.5%) reactivity groups. Prenatal tobacco exposure was associated with higher likelihood of membership in the elevated reactivity compared to the moderate reactivity group. Higher caregiver sensitivity in early life was associated with lower likelihood of membership in the elevated reactivity group. Prenatal cocaine exposure was associated with higher maternal harshness. Interaction effects among early\u2010life adversity and parenting indicated that caregiver sensitivity buffered, and harshness exacerbated, the likelihood that high early adversity would be associated with the elevated and blunted reactivity groups. Results highlight the potential importance of prenatal alcohol and tobacco exposure for cortisol reactivity and the role of parenting as exacerbating or buffering the impact of early\u2010life adversity on adolescent stress response.<\/jats:p>","DOI":"10.1002\/dev.22365","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T13:00:09Z","timestamp":1673355609000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Prenatal substance exposure, early\u2010life adversity, and parenting: Associations with adolescent stress response"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5303-3661","authenticated-orcid":false,"given":"Rina D.","family":"Eiden","sequence":"first","affiliation":[{"name":"Department of Psychology and The Social Science Research Institute The Pennsylvania State University  State College Pennsylvania 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