Toddler’s Cognitive Development Could Be Impaired by Stress, Anxiety and Depression During Pregnancy

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Pregnant Woman Sad Depressed

A mother’s stress, anxiety, and depression during pregnancy could result in impaired cognitive development in offspring at 18 months.

Women’s elevated anxiety, depression, and stress during pregnancy altered key features of the fetal brain, subsequently resulting in reduced cognitive development in their offspring at 18 months. These changes also increased internalizing and dysregulation behaviors, according to a new research study by Children’s National Hospital published today (April 29, 2022) in JAMA Network Open. A group of 97 pregnant women and their kids were monitored by the researchers. Furthermore, the data show that chronic psychological discomfort distress the baby is delivered may alter parent-child interaction and infant self-regulation.

This is the first study to shed light on an important link between altered in-utero fetal brain development and the long-term cognitive development consequences for fetuses exposed to high levels of toxic stress during pregnancy. The researchers detected alterations in sulcal depth and left hippocampus volume while in the womb, which could explain the neurodevelopment abnormalities observed after birth. When these children grow into toddlers, they may develop persistent social-emotional issues and have trouble establishing healthy relationships with others, including their moms. Future studies with a bigger sample size that includes additional regions and populations are needed to corroborate this. 

Catherine Limperopoulos

Catherine Limperopoulos, Ph.D., chief and director of the Developing Brain Institute at Children’s National and senior author of the study. Credit: Children’s National Hospital

“By identifying the pregnant women with elevated levels of psychological distress, clinicians could recognize those babies who are at risk for later neurodevelopmental impairment and might benefit from early, targeted interventions,” said Catherine Limperopoulos, Ph.D., chief and director of the Developing Brain Institute at Children’s National and senior author of the study.

Regardless of their socioeconomic status, about one of every four pregnant women suffers from stress-related symptoms, the most common pregnancy complication. The relationship between altered fetal brain development, prenatal maternal psychological distress and long-term neurodevelopmental outcomes remain unknown. Studying in utero fetal brain development poses challenges due to fetal and maternal movements, imaging technology, signal-to-noise ratio issues and changes in brain growth.

All pregnant participants were healthy, most had some level of education and were employed. To quantify prenatal maternal stress, anxiety and depression, the researchers used validated self-reported questionnaires. Fetal brain volumes and cortical folding were measured from three-dimensional reconstructed images derived from MRI scans. Fetal brain creatine and choline were quantified using proton magnetic resonance spectroscopy. The 18-month child neurodevelopment was measured using validated scales and assessments.

This study builds upon previous work from the Developing Brain Institute led by Limperopoulos, which discovered that anxiety in pregnant women appears to affect the brain development of their babies. Her team also found that maternal mental health, even for women with high socioeconomic status, alters the structure and biochemistry of the developing fetal brain. The growing evidence underscores the importance of mental health support for pregnant women.

“We’re looking at shifting the health care paradigm and adopting these changes more broadly to better support moms,” said Limperopoulos. “What’s clear is early interventions could help moms reduce their stress, which can positively impact their symptoms and thereby their baby long after birth.”

Reference: “Association of Elevated Maternal Psychological Distress, Altered Fetal Brain, and Offspring Cognitive and Social-Emotional Outcomes at 18 Months” 29 April 2022, JAMA Network Open.
DOI: 10.1001/jamanetworkopen.2022.9244





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