Maternal antenatal anxiety and behavioural/emotional problems in children: a test of a programming hypothesis


Thomas G. O'Connor, Departments of Child & Adolescent Psychiatry and Social, Genetic & Developmental Psychiatry, Institute of Psychiatry, Box P080, 111 Denmark Hill, London SE5 8AF, UK; Email:


Background: Previous animal investigations link antenatal stress with a range of persistent behavioural abnormalities in the offspring. The current study examined if the effect was also found in humans through middle childhood.

Methods: The current study is based on the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective, community-based study that has followed a cohort of women from pregnancy. Self-report measures of maternal anxiety and depression were assessed at repeated intervals in pregnancy and the postnatal period. Children's behavioural/emotional problems were assessed by parent report at age 47 and 81 months. Information on obstetric and psychosocial factors was obtained at several points in pregnancy and the postnatal period.

Results: Children whose mothers experienced high levels of anxiety in late pregnancy exhibited higher rates of behavioural/emotional problems at 81 months of age after controlling for obstetric risks, psychosocial disadvantage, and postnatal anxiety and depression (for girls, OR = 1.91, 95%CI = 1.26–2.89; for boys, OR = 2.16, 95%CI = 1.41–3.30). Furthermore, the effect at 81 months was comparable to what was previously obtained at 47 months, suggesting the kind of persistent effect proposed in the animal literature.

Conclusions: There is evidence that antenatal stress/anxiety has a programming effect on the fetus which lasts at least until middle childhood.