Perinatal Maternal Distress and Neurobehavioural Development in Toddlers

Background Maternal perinatal psychological distress (e.g., anxiety, depression) is common and has been linked to adverse child behavioural outcomes. Altered brain function provides a potential mechanism through which perinatal distress may impact child behaviour, but specific associations remain unclear. This study investigated associations between perinatal distress, child brain functional connectivity at 2 years, and child behaviour at 2 and 3 years. Methods Neuroimaging and behavioural data were obtained from the Pregnancy during the COVID-19 Pandemic (PdP) study. Maternal distress (anxiety and depression symptoms) was self-reported throughout the perinatal period; analyses included measures from intake survey and 2 years postpartum. Child behaviour at 2 and 3 years was parent-reported using the Ages and Stages Questionnaire (ASQ-3). Resting-state fMRI data was collected at 2 years (n=62) to quantify connectivity within the default mode, executive control, frontoparietal, and sensorimotor networks. Associations between maternal prenatal and postnatal distress, child functional connectivity, and child behaviour were examined using regression models. Results Postnatal, but not prenatal, distress was associated with lower gross motor scores at 2 years (B=-0.5, T=-2.8, p=0.005, df=3517, q=0.01). Higher distress both prenatally and postnatally was associated with lower ASQ-3 scores at 3 years across all domains (q < 0.05). Child brain connectivity was not related to maternal distress or behaviour. Conclusions Perinatal distress was associated with worse behaviour at 2 and 3 years, although no associations with connectivity were observed, suggesting other pathways may underlie these effects. Nonetheless, these findings highlight the importance of supporting mental health during pregnancy and postnatally to promote healthy child development.