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Although numerous researchers have examined the potentially harmful effects of psychotropic medications on the developing fetus, few have investigated the effects of the mother's emotional symptoms on the fetus. However, a wealth of animal data links maternal antenatal stress to behavioral effects in offspring. In this population-based study, researchers surveys 12,998 pregnant English women at multiple timepoints for prenatal and postnatal anxiety, depression, pregnancy risks and psychosocial stressors. Because of attrition by the study population and use of strict time frames for completing the self-report questionnaires, data on only 7448 women were analyed. Standard scales were used to assess parental reports of behavioral problems in the child at 4 years (difficulties with conduct, inattention/hyerpactivity and emotional distress). After obstetric risks, psychological stress and postnatal anxiety and depression were controlled for, prenatal anxiety in late pregnancy was a significant predictor of total behavior problems in boys and girls (odds ratios, 1.56 and 1.51, respectively), emotional distress in boys and girls (ORs, 1.56 and 1.39), and inattention/hyperactivity in boys (OR, 1.85). Comment: These finds suggest that prenatal maternal anxiety has direct adverse effects on the developing brain of the feuts and contributes to later behavioral problems in the child. Because postnatal anxiety was controlled for, the effect of maternal prenatal anxiety on the child probably does not reflect the child's genetic vulnerability to anxiety. The presence of reporter bias was unlikely because the effect persisted after adjustment for prenatal and postnatal depression. Maternal anxiety may alter activity in the hypothalmaic-pituitary-adrenal axis, which has been shown to mediate stress-behavior relations in animals and humans. |
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Peter Roy-Byrne, MD
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