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What is the effect of maternal prenatal stress on childhood mental health?

A new study has found a direct association between maternal prenatal stress and negative outcomes of offspring psychopathology.

Maternal prenatal stress can be defined as a reduction in the mother’s psychological well-being during pregnancy and is linked to neurobiological, behavioural, and cognitive outcomes in offspring. Prenatal anxiety can also affect childhood psychopathology (manifestation of symptoms indicative of mental illness or distress). It is important to note that 50% of mental health disorders develop before the age of five, whilst 75% appear before adulthood. At present, limited work is available on the effects of prenatal adversity on offspring mental health since studies have primarily focused on the postnatal period.

In a research paper published in the Journal of the American Academy of Child & Adolescent Psychiatry, researchers considered the impact of specific prenatal symptoms and pregnancy-specific worries on early offspring psychopathology.

Results were obtained from three large, independent pregnancy cohorts of the DREAM-BIG (Developmental Research in Environmental Adversity, Mental health, BIological susceptibility, and Gender) consortium. This international project aimed to observe the overall mood of mothers during pregnancy and their consequences for the offspring. Firstly, the maternal prenatal mood was examined using different assessment measures in all three cohorts. Assessment types included a self-report questionnaire based on the Edinburgh Postnatal Depression Scale (EPDS) determining general depressive symptoms at 18 weeks of pregnancy, as well as evaluation of symptoms related to prenatal mood, appetite, and sleep using the Center for Epidemiologic Studies Depression Scale (CES-D) at 24 to 26 weeks of gestation. Then, offspring psychopathology data was collected from the ages of four to eight using self-, parental-, teacher-, and observer-rated measures.

The general affective symptoms that were detected in expectant mothers were similar in all three cohorts and specifically involved general anxiety and depression, somatic factors and pregnancy-specific worries. Both the general affective symptoms and the three specific stress factors were independently linked to offspring mental health.

Maternal prenatal stress impacts child’s mental health

It was found that maternal prenatal stress distinctly predicted mental health disorders in the offspring between the ages of four and eight. There was a further association between prenatal stress and early risk for children’s internalising problems, such as anxiety and depression. These mental health disorders can persist long term. However, there was no such relationship between prenatal stress and externalising issues (such as antisocial behaviour and conduct disorder) in this study.

The current COVID-19 pandemic is an additional factor that may cause anxiety for pregnant women due to mortality rates, risk of infection and social distancing from loved ones. The first author on the research paper, Dr. Eszter Szekely (McGill University), stated, “Of course, there are multiple factors at play, including genetics, sex and gender, and the environment after birth, but when you combine maternal stress with this particular environmental adversity, you have the potential for greater mental health challenges for children who are born into this post-pandemic world”.

Making mental health a priority

This study highlights the need for mental health to be a priority throughout life, starting from gestation. It is clear that all mothers need to be provided with prenatal mental health resources. For women experiencing pregnancy-specific worries, targeted intervention is required in the prenatal period to specifically address the negative emotions and fears related to the actual pregnancy. For this, the researchers suggest the use of questionnaires by clinicians to assess pregnancy-specific anxiety and group therapy led by midwives and psychologists. It is imperative that protective measures are put in place to alleviate both prenatal maternal anxiety and the consequent adverse impact on children’s mental health.

Written by Albina Babu, MSc


1. Szekely, E., et al. (2020). Maternal prenatal mood, pregnancy-specific worries, and early child psychopathology: findings from the DREAM BIG Consortium. Journal of the American Academy of Child & Adolescent Psychiatry.

2. COVID-19 places added prenatal stress on mother and child that could have lasting impact (May 11, 2020). Retrieved from:

Image by Madalin Calita from Pixabay 



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