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Maternal Anxiety Alters Fetal Brain Programming

December 15, 2020

A study that used resting-state functional magnetic resonance imaging (fMRI) to investigate neural circuitry in fetuses suggests that anxiety in pregnant women affects brain development in the womb. Researchers reported their findings online in JAMA Network Open.

“Our study is, to our knowledge, the first to report an association between maternal trait and state anxiety and altered fetal functional brain connectivity,” they wrote, “supporting a fetal programming hypothesis.” 

The study included 50 healthy pregnant volunteers from low-risk prenatal clinics in the Washington, DC, area. Participants completed validated questionnaires to screen for stress, anxiety, and depression and underwent resting-state fMRI at Children’s National Hospital in Washington, DC. The women were between 24 weeks and 39 weeks into their pregnancies.

Preterm Birth, Poor Fetal Growth Linked With Increased Depression Risk

Women with higher scores of either trait or state anxiety were more likely to have fetuses with stronger connections between the brainstem and sensorimotor areas, which are associated with arousal and sensorimotor skills, researchers reported. Women with higher anxiety were also more likely to have fetuses with weaker connections between the parieto-frontal and occipital association cortices, which are involved in executive and higher-level cognitive functions.

“These findings are pretty much in keeping with previous studies that show disturbances in connections reported in the years and decades after birth of children born to women with anxiety,” said study author and scientist Josepheen De Asis-Cruz, MD, PhD, of Children’s National Hospital.

The early onset of such functional deviations revealed in the study, however, suggests the need for widespread screening of anxiety in women during pregnancy.

“Mental health problems remain taboo, especially in the peripartum period where the expectation is that this is a wonderful time in a woman’s life. Many pregnant mothers aren’t getting the support they need,” said study author Catherine Limperopoulos, PhD, director of the Developing Brain Institute at Children’s National Hospital. “Changes at the systems level will be necessary to chip away at this critical public health problem and make sure that both mothers and babies thrive in the short and long term.”

—Jolynn Tumolo 


De Asis-Cruz J, Krishnamurthy D, Zhao L, et al. Association of prenatal maternal anxiety with fetal regional brain connectivity. JAMA Network Open. 2020;3(12):e2022349.

Maternal anxiety affects the fetal brain [press release]. Washington, DC: Children’s National; December 7, 2020.

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