Prenatal stress and children’s behavior: What expectant parents should know

Key takeaways for caregivers

• Mental health support during pregnancy benefits both parents and children.
• Research shows that pregnant adults’ psychological distress during pregnancy has small but lasting effects on their children’s behavioral development.
• Effects persist independently of post-pregnancy mental health.
• Providing accessible mental health care during pregnancy could help prevent children’s behavior challenges.
• Early screening and support for psychological distress during pregnancy is important.

Pregnancy can be both an exciting and a challenging time. Parents often wonder how their experiences during pregnancy might affect their developing child. New research I conducted with colleagues analyzing data from across five continents provides important insights about the relation between psychological distress during pregnancy and children’s later behavioral development.

Why focus on mental health during pregnancy?

The transition to parenthood often brings increased contact with health care providers, making pregnancy an ideal time to screen for and address mental health concerns. Yet for many pregnant people, experiences of anxiety or depression go undetected and untreated. Understanding how psychological well-being during pregnancy affects children’s development can help make the case for better mental health support during this critical period.

What did the research find?

In our analysis, experiencing psychological distress (e.g., anxiety, depression) at high levels during pregnancy was associated with a small but meaningful increase in children’s behavioral challenges later in life. In the studies we reviewed, pregnant individuals’ psychological distress included current and recent experiences of depression, anxiety, and perceived stress measured by standardized questionnaires during pregnancy. Most studies assessed these experiences during the second or third trimester of pregnancy.

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Children’s behavioral challenges involved difficulties with emotional and behavioral regulation, including more severe or more frequent aggressive behaviors, problems with attention and hyperactivity, and oppositional behaviors. The effects of psychological distress during pregnancy showed up across childhood and into the teenage years, although they appeared slightly more pronounced in early childhood (ages two to five).

Importantly, these effects remained even after accounting for pregnant parents’ mental health after pregnancy. This suggests that the pregnancy period itself may be especially important for supporting parents’ and children’s well-being.

Several biological mechanisms may explain these effects. During pregnancy, high levels of psychological distress can affect maternal stress hormones and inflammatory markers that influence fetal brain development, particularly in regions involved in emotion and behavior regulation. These early changes may shape how children respond to their environment after birth.

Not all countries or cultures in the world were equally represented in these analyses: Specifically, our meta-analysis included studies from across five continents, with most studies coming from Europe (16 studies) and North America (13 studies) or both (1 study), and fewer coming from Australia/Oceania (3 studies), Asia (2 studies), and South America (1 study).

In addition, most studies featured predominantly White (77%) samples, and most participants had relatively high levels of education and income. More research is needed with racially and socioeconomically diverse families to better understand how these patterns differ across cultures and socioeconomic backgrounds.

What does this mean for parents?

The transition to parenthood brings significant physical, emotional, and life changes that can affect mental well-being. The hormonal changes of pregnancy can affect mood and stress levels, and many pregnant individuals experience ups and downs in mood and varying levels of stress during pregnancy.

Research suggests that a significant number of pregnant individuals experience clinical levels of depression or anxiety during pregnancy.

However, for some individuals, psychological distress in pregnancy goes beyond these typical experiences. Clinical levels of depression and anxiety can emerge or worsen at this time – not just after birth as is commonly understood. Research suggests that a significant number of pregnant individuals experience clinical levels of depression or anxiety during pregnancy.

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Individuals experiencing persistent low mood, anxiety, or other psychological distress during pregnancy are not alone. They can talk with their health care providers to learn about the many effective, pregnancy-safe treatments available. Prioritizing mental health during this important transition is valuable for both parents’ and children’s well-being.

Among the signs that may indicate that a pregnant person needs additional support:

• Persistent sadness or anxiety lasting more than two weeks,
• Loss of interest in typically enjoyed activities,
• Significant sleep problems (beyond typical pregnancy-related sleep changes),
• Feelings of worthlessness or hopelessness, and
• Thoughts of self-harm.

Supporting the mental health of expectant parents is a worthy investment that benefits both parents and children.

Although our findings highlight links between prenatal psychological distress and children’s later behavior, the effects were relatively small. Many other factors influence children’s development. Rather than cause worry, these results should encourage:

• Normalizing conversations about mental health during pregnancy,
• Making mental health screening a routine part of prenatal care,
• Ensuring that pregnant individuals have access to mental health support when needed,
• Removing barriers and stigma around seeking help, and
• Supporting policies that make mental health care more accessible during pregnancy.

Looking ahead

As we continue to unravel the complex interplay between prenatal experiences and children’s development, one thing is clear: Supporting the mental health of expectant parents is a worthy investment that benefits both parents and children.

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