Re-examining the link between prenatal maternal anxiety and child emotional difficulties, using a sibling design

Abstract

Our finding lends little support for there being an independent prenatal effect on child emotional difficulties; rather, our findings suggest that the link between prenatal maternal anxiety and child difficulties could be confounded by pleiotropic genes or environmental family factors.

Adverse family life events during pregnancy and ADHD symptoms in five‐year‐old offspring

“…might be explained by recall bias since exposure was retrospectively assessed in the study, and mothers’ reports might therefore be influenced by whether their children expressed ADHD symptoms. Our findings are also similar to the results from two previous studies based on MoBa, where maternal distress (anxiety or depression) during pregnancy was associated with behavior problems in offspring at a population level, but not in sibling‐comparison analyses (Bekkhus et al., ; Gjerde et al., ). We expand further on these results by specifically assessing the effect of stressful life events on ADHD symptoms.…”

“…However, a cross‐fostering study found a statistically significant association between prenatal stress and ADHD symptoms only among children genetically related to their mothers, but not among unrelated mother‐offspring pairs (β = .163, p = .001, compared to β = .095, p = .25)(Rice et al., ), indicating that the association may, at least partly, be explained by genetic confounding. Furthermore, in two recent large sibling‐comparisons based on the longitudinal Norwegian Mother and Child Cohort Study, emotional distress during pregnancy was not associated with offspring emotional difficulties at 6 and 36 months (Bekkhus et al., ), or with internalizing and externalizing behavior at age 5 (Gjerde et al., ) after adjusting for familial confounds. Therefore, it remains uncertain if the association between prenatal exposure to adverse life events and ADHD symptoms in childhood reflects a causal association or if it could be explained by unmeasured genetic confounding.…”

Maternal Perinatal and Concurrent Anxiety and Mental Health Problems in Early Childhood: A Sibling‐Comparison Study

“…Alternatively, the same genes might be influencing both the parent and child phenotype, or aspects of the shared family environment may contribute both to a higher risk for anxiety in the mother and mental health problems in the child. Our control for such unmeasured genetic and shared environmental confounding through the sibling comparison analyses indicated that associations between perinatal measures of maternal anxiety symptoms and internalizing problems are confounded by genetic and environmental influences shared between mothers and children, in line with previous studies (e.g., Bekkhus et al., ). Only maternal concurrent anxiety symptoms remained significantly associated with preschool offspring's internalizing problems.…”

“…However, a notable exception was recently found in a Norwegian prospective study, also using MoBa data (described below). The authors concluded that exposure to maternal prenatal anxiety was not associated with child internalizing symptoms in 6 and 36 months old children after sibling comparison (Bekkhus et al., ). However, the study did not include measures of externalizing symptoms in the children, nor adjust for maternal depressive symptoms or concurrently measured maternal anxiety symptoms.…”

Maternal prenatal depressive symptoms and risk for early-life psychopathology in offspring: genetic analyses in the Norwegian Mother and Child Birth Cohort Study

“…This is because alleles from the mother and father are randomly distributed during gamete formation. Large-scale applications of this method have recently indicated a likely role for a genetic mechanism of risk transmission between maternal prenatal anxiety and offspring behavioral difficulties at 6 and 36 months 18 and between maternal prenatal depressive symptoms and child psychopathology during early childhood 19 . These applications show the power of this method when combined with large samples of siblings -which, especially when compared to IVF families, are relatively straightforward to obtain 14 .…”