Archives of Women's Mental Health

, Volume 13, Issue 1, pp 61–74 | Cite as

A systematic review of the effects of postnatal maternal anxiety on children

  • Cristie Glasheen
  • Gale A. Richardson
  • Anthony Fabio
Review Article


Several decades of research have focused on the impact of exposure to postnatal depression on children, while anxiety has been largely overlooked. Estimates of the prevalence of postnatal maternal anxiety (PMA) range from 3% to 43%, suggesting PMA may be an important risk factor for adverse outcomes in children. This review summarizes what is known about the effects of PMA exposure on children and makes recommendations for future research. A systematic search of Ovid MEDLINE® and PsychINFO® through 2008 identified 18 studies that evaluated child outcomes associated with PMA exposure. Identified studies covered three domains: somatic, developmental, and psychological outcomes. The strongest evidence for an adverse effect of PMA exposure is in somatic and psychological outcomes; the evidence for an effect of PMA on child development is inconclusive. Methodological differences among the studies make comparisons difficult and there are a number of common limitations that challenge the validity of these studies.


Postnatal Postpartum Anxiety Depression Review Child development 


  1. Achenbach TM (1991a) Manual for the Child Behavior Checklist 4–18 and 1991 profile. University of Vermont, Department of Psychiatry, BurlingtonGoogle Scholar
  2. Achenbach TM (1991b) Manual for the Teacher’s Report Form and 1991 profile. University of Vermont, Department of Psychiatry, BurlingtonGoogle Scholar
  3. Akman I, Kuscu K, Ozdemir N, Yurdakul Z, Solakoglu M, Orhan L et al (2006) Mothers’ postpartum psychological adjustment and infantile colic. Arch Dis Child 91(5):417–419CrossRefPubMedGoogle Scholar
  4. Andrews G, Sanderson K, Slade T, Issakidis C (2000) Why does the burden of disease persist? Relating the burden of anxiety and depression to effectiveness of treatment. Bull World Health Organ 78(4):446–454PubMedGoogle Scholar
  5. Ayers S (2001) Assessing psychopathology in pregnancy and postpartum. J Psychosom Obstet Gynaecol 22(2):91–102CrossRefPubMedGoogle Scholar
  6. Barnes LB, Harp D, Jung WS (2002) Reliability generalization of scores on the Spielberger State–Trait Anxiety Inventory. Educ Psychol Measur 62(4):603–618CrossRefGoogle Scholar
  7. Barnett B, Parker G (1986) Possible determinants, correlates and consequences of high levels of anxiety in primiparous mothers. Psychol Med 16(1):177–185CrossRefPubMedGoogle Scholar
  8. Barnett B, Schaafsma MF, Guzman AM, Parker GB (1991) Maternal anxiety: a 5-year review of an intervention study. J Child Psychol Psychiatry 32(3):423–438CrossRefPubMedGoogle Scholar
  9. Bates JE, Freeland CA, Lounsbury ML (1979) Measurement of infant difficultness. Child Dev 50(3):794–803CrossRefPubMedGoogle Scholar
  10. Birtchnell J, Evans C, Kennard J (1988) The total score of the Crown-Crisp Experiential Index: a useful and valid measure of psychoneurotic pathology. Br J Med Psychol 61(Pt 3):255–266PubMedGoogle Scholar
  11. Brouwers EP, van Baar AL, Pop VJ (2001) Does the Edinburgh Postnatal Depression Scale measure anxiety? J Psychosom Res 51(5):659–663CrossRefPubMedGoogle Scholar
  12. Carey WB (1963) Maternal anxiety and infantile colic. Is there a relationship? Clin Pediatr 7(10):590–595CrossRefGoogle Scholar
  13. Carey WB, McDevitt SC (1978) Revision of the Infant Temperament Questionnaire. Pediatrics 61(5):735–739PubMedGoogle Scholar
  14. Cohen S, Kamarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24(4):385–396CrossRefPubMedGoogle Scholar
  15. Coplan R, O’Neil K, Arbeau KA (2005) Maternal anxiety during and after pregnancy and infant temperament at three months of age. J Prenat Perinat Psychol Health 19(3):199–215Google Scholar
  16. Coulthard H, Harris G (2003) Early food refusal: the role of maternal mood. J Reprod Infant Psychol 21(4):335–345CrossRefGoogle Scholar
  17. Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786CrossRefPubMedGoogle Scholar
  18. Davis E, Snidman N, Wadhwa P, Glynn L, Schetter C, Sandman C (2004) Prenatal maternal anxiety and depression predict negative behavioral reactivity in infancy. Infancy 6(3):319–331CrossRefGoogle Scholar
  19. Dawson G, Ashman SB, Carver LJ (2000) The role of early experience in shaping behavioral and brain development and its implications for social policy. Dev Psychopathol 12(4):695–712CrossRefPubMedGoogle Scholar
  20. de Weerth C, Buitelaar JK (2005) Physiological stress reactivity in human pregnancy—a review. Neurosci Biobehav Rev 29(2):295–312CrossRefPubMedGoogle Scholar
  21. Diener M, Goldstein L, Mangelsdorf S (1995) The role of prenatal expectations in parent’s reports of infant temperament. Merill-Palmer Quarterly 41(2):172–190Google Scholar
  22. Frankenburg WK, Fandal AW, Thornton SM (1987) Revision of Denver Prescreening Developmental Questionnaire. J Pediatr 110:653–657CrossRefPubMedGoogle Scholar
  23. Galler JR, Harrison RH, Ramsey F, Forde V, Butler SC (2000) Maternal depressive symptoms affect infant cognitive development in Barbados. J Child Psychol Psychiatry 41(6):747–757CrossRefPubMedGoogle Scholar
  24. Galler JR, Harrison RH, Ramsey F, Butler S, Forde V (2004a) Postpartum maternal mood, feeding practices, and infant temperament in Barbados. Infant Behav Dev 27(3):267–287CrossRefGoogle Scholar
  25. Galler JR, Ramsey FC, Harrison RH, Taylor J, Cumberbatch G, Forde V (2004b) Postpartum maternal moods and infant size predict performance on a national high school entrance examination. J Child Psychol Psychiatry 45(6):1064–1075CrossRefPubMedGoogle Scholar
  26. Goodman R, Scott S (1999) Comparing the Strengths and Difficulties Questionnaire and the Child Behavior Checklist: is small beautiful? J Abnorm Child Psychol 27(1):17–24CrossRefPubMedGoogle Scholar
  27. Griffiths R (1954) The abilities of babies. University of London Press, LondonGoogle Scholar
  28. Heron J, O’Connor TG, Evans J, Golding J, Glover V (2004) The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80(1):65–73CrossRefPubMedGoogle Scholar
  29. Kabir K, Sheeder J, Kelly LS (2008) Identifying postpartum depression: are 3 questions as good as 10? Pediatrics 122(3):e696–e702CrossRefPubMedGoogle Scholar
  30. Kagan J, Snidman N (1991) Temperamental factors in human development. Am Psychol 46(8):856–862CrossRefPubMedGoogle Scholar
  31. Kuo WH, Wilson TE, Holman S, Fuentes-Afflick E, O’Sullivan MJ, Minkoff H (2004) Depressive symptoms in the immediate postpartum period among Hispanic women in three U.S. cities. J Immigr Health 6(4):145–153CrossRefPubMedGoogle Scholar
  32. Masi G, Millepiedi S, Mucci M, Poli P, Bertini N, Milantoni L (2004) Generalized anxiety disorder in referred children and adolescents. J Am Acad Child Adolesc Psychiatry 43(6):752–760CrossRefPubMedGoogle Scholar
  33. Matthey S, Barnett B, Howie P, Kavanagh DJ (2003) Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety? J Affect Disord 74(2):139–147CrossRefPubMedGoogle Scholar
  34. McMahon C, Barnett B, Kowalenko N, Tennant C, Don N (2001) Postnatal depression, anxiety and unsettled infant behaviour. Aust NZ J Psychiatry 35(5):581–588CrossRefGoogle Scholar
  35. Morissette SB, Tull MT, Gulliver SB, Kamholz BW, Zimering RT (2007) Anxiety, anxiety disorders, tobacco use, and nicotine: a critical review of interrelationships. Psychol Bull 133(2):245–272CrossRefPubMedGoogle Scholar
  36. Muthén B (2004) Latent variable analysis: growth mixture modeling and related techniques for longitudinal data. In: Kaplan D (ed) Handbook of quantitative methodology for the social sciences. Sage, Newbury Park, pp 345–368Google Scholar
  37. Nagin DS (1999) Analyzing developmental trajectories: a semiparametric, group-based approach. Psychol Methods 4(2):139–157CrossRefGoogle Scholar
  38. Nicol-Harper R, Harvey AG, Stein A (2007) Interactions between mothers and infants: impact of maternal anxiety. Infant Behav Dev 30(1):161–167CrossRefPubMedGoogle Scholar
  39. Oberklaid F, Sanson AV, Prior M (1986) The development of Australian normative data for infant temperament. Aust Paediatr J 22(3):185–187PubMedGoogle Scholar
  40. O’Connor TG, Heron J, Golding J, Beveridge M, Glover V (2002) Maternal antenatal anxiety and children’s behavioural/emotional problems at 4 years. Report from the Avon Longitudinal Study of Parents and Children. Br J Psychiatry 180:502–508CrossRefPubMedGoogle Scholar
  41. O’Connor TG, Heron J, Golding J, Glover V (2003) Maternal antenatal anxiety and behavioural/emotional problems in children: a test of a programming hypothesis. J Child Psychol Psychiatry 44(7):1025–1036CrossRefPubMedGoogle Scholar
  42. Pesonen A, Raikkonen K, Strandberg T, Jarvenpaa A (2005) Continuity of maternal stress from the pre- to postnatal period: association with infant’s positive, negative, and overall temperamental reactivity. Infant Behav Dev 28:36–47CrossRefGoogle Scholar
  43. Ramchandani PG, Stein A, Hotopf M, Wiles NJ (2006) Early parental and child predictors of recurrent abdominal pain at school age: results of a large population-based study. J Am Acad Child Adolesc Psychiatry 45(6):729–736CrossRefPubMedGoogle Scholar
  44. Rothbart M (1981) Measurement of temperament in infancy. Child Dev 52:569–578CrossRefGoogle Scholar
  45. Rothbart MK, Ahadi SA, Hershey KL, Fisher P (2001) Investigations of temperament at three to seven years: the Children’s Behavior Questionnaire. Child Dev 72(5):1394–1408CrossRefPubMedGoogle Scholar
  46. Seckl JR, Holmes MC (2007) Mechanisms of disease: glucocorticoids, their placental metabolism and fetal ‘programming’ of adult pathophysiology. Nat Clin Pract Endocrinol Metab 3(6):479–488CrossRefPubMedGoogle Scholar
  47. Slykerman RF, Thompson JM, Clark PM, Becroft DM, Robinson E, Pryor JE et al (2007) Determinants of developmental delay in infants aged 12 months. Paediatr Perinat Epidemiol 21(2):121–128CrossRefPubMedGoogle Scholar
  48. Speilberger CD (1977) State–Trait Anxiety Inventory: self-evaluation questionnaire. Consulting Psychologists, Palo AltoGoogle Scholar
  49. Spielberger C, Gorsuch R, Lushene R, Vagg P, Jacobs G (1983) Manual for the State–Trait Anxiety Inventory: STAI. Mindgarden, San DiegoGoogle Scholar
  50. Susman EJ, Schmeelk KH, Ponirakis A, Gariepy JL (2001) Maternal prenatal, postpartum, and concurrent stressors and temperament in 3-year-olds: a person and variable analysis. Dev Psychopathol 13(3):629–652CrossRefPubMedGoogle Scholar
  51. Watson D, O’Hara MW, Simms LJ, Kotov R, Chmielewski M, McDade-Montez EA et al (2007) Development and validation of the Inventory of Depression and Anxiety Symptoms (IDAS). Psychol Assess 19(3):253–268CrossRefPubMedGoogle Scholar
  52. Wenzel A, Haugen EN, Jackson LC, Robinson K (2003) Prevalence of generalized anxiety at eight weeks postpartum. Arch Womens Ment Health 6(1):43–49CrossRefPubMedGoogle Scholar
  53. Zung WW (1971) A rating instrument for anxiety disorders. Psychosomatics 12(6):371–379PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Cristie Glasheen
    • 1
  • Gale A. Richardson
    • 1
  • Anthony Fabio
    • 1
  1. 1.University of PittsburghPittsburghUSA

Personalised recommendations