Antenatal maternal anxiety is associated with problem behaviour at age five

Background: Developmental programming by maternal stress during pregnancy is found to influence behavioural development in the offspring. Aim: To prospectively investigate the association between antenatal maternal anxiety and children's behaviour rated by their mothers and teachers. Methods: In a large, community based birth-cohort (the ABCD-study) antenatal maternal state-anxiety (M = 36.7, SD = 9.8) was measured around the 16th week of gestation. Five years later, 3446 mothers and 3520 teachers evaluated 3758 children's overall problem behaviour, emotional symptoms, conduct problems, hyperactivity/inattention problems, peer relationship problems and pro-social behaviour. Results: Hierarchical multiple regression analysis using a large number of potential covariates revealed that children of mothers who reported higher levels of anxiety during their pregnancy showed more overall problem behaviour, hyperactivity/inattention problems, emotional symptoms, peer relationship problems, conduct problems and showed less pro-social behaviour when mothers rated their child's behaviour. When teachers rated child behaviour, children showed more overall problem behaviour and less pro-social behaviour that was related to antenatal anxiety. The child's sex moderated the association between antenatal anxiety with overall problem behaviour and hyperactivity/inattention problems when reported by the mother. In boys, exposure to antenatal anxiety was associated with a stronger increase in overall problem behaviour compared to girls. Furthermore, antenatal anxiety was significantly related to an increase in hyperactivity/inattention problems in boys, while this was not the case in girls. Conclusions: Exposure to antenatal maternal anxiety is associated with children's problem behaviour, with different outcome patterns for both sexes. Nevertheless, effect sizes in this study were small. (C) 2011 Elsevier Ireland Ltd. All rights reserved.