Affecttive Development of Children Due to Anxiety During Pregnancy : A Literature Review

Given its potential to affect the growing fetus, maternal mental health during pregnancy is essential. Anxiety during pregnancy is associated with the socio-emotional development of the child, potentially resulting in behavioral and emotional issues in the future. Children of mothers who experience anxiety during pregnancy are predicted to experience poorer growth and development in infancy and preschool age. This study aims to determine the effects of anxiety during pregnancy. This study used a literature review approach from 8 relevant articles from the online databases Scopus, PubMed, Google Scholar, and Garuda. The inclusion criteria of this study were original research in Indonesian or English, respondents measured anxiety during pregnancy, and measurement of infant/child affective patterns, which were fully accessible. The findings indicated that a child’s affective development and anxiety during pregnancy are significantly correlated. It can be characterised by decreased attention to facial expressions in infants crying, sleeping, and feeding. In addition, the child may experience impaired socio-individual neurodevelopment, fine motor and emotional development, and poorer language. This can lead to negative behavioral development, such as hyperactivity and emotional disturbances, from preschool to adulthood. The more often and longer the mother experiences anxiety, the more likely the child is to have emotional and behavioral disorders.

INTRODUCTION

In a clinical and public health context, anxiety is a significant health risk. This includes that experienced by pregnant women. Women who experience significant physical and psychological changes during pregnancy are more likely to experience symptoms of anxiety and depression¹¹.

Pregnancy-related anxiety is detrimental to both the mother’s and the child’s health²². Pregnant women who have it are more likely to have a caesarean delivery and to experience eating disorders³³, increasing the prevalence of depression⁴⁴, decreased sleep quality⁵⁵, increased risk of suicide⁶⁶, and postpartum emotions and negative parenting behaviors⁷⁷. Feelings of fear and worry are hallmarks of mental health conditions known as anxiety disorders, which usually arise as a response to excessive fear or excessive worry about a particular situation⁸⁸. Anxiety in pregnant women depends on the risk factors that affect it. The higher the risk factors for pregnant women’s pregnancy, the higher the anxiety level of the mother^9,10910.

Maternal mental health during pregnancy should be of particular concern as it can potentially hurt the developing fetus⁸⁸both physiologically, emotionally, and cognitively¹¹¹¹. A lower gestational age is linked to anxiety throughout pregnancy. And hurts fetal neurodevelopment and childbirth outcomes¹²¹². Among them may increase the risk of low birth weight¹³¹³, allergic disorders^14,151415, increased risk of childhood asthma and poorer growth in infancy and preschool age¹⁶¹⁶, higher body mass index at 54 months of age¹⁷¹⁷, emotional and behavioral problems¹⁸¹⁸, lower estimates of infant brain development¹⁹¹⁹, and negative temperament²⁰²⁰in their children.

Because of the fetus’s quick development, early life events can affect neurodevelopment, potentially increasing susceptibility to developmental and neuropsychiatric problems²¹²¹. Maternal control of emotional states is critical for children during pregnancy and childhood²²²². Mothers who manage their emotions are less likely to experience affective problems in infants²³²³. Nevertheless, stress, anxiety, and depression during pregnancy frequently go undiagnosed by medical practitioners and are poorly managed²⁴²⁴. Given that the prevalence of anxiety and depressive symptoms during pregnancy and after childbirth varies widely across regions and poses significant risks to mothers and their babies, this study aimed to describe the effects that anxiety during pregnancy can have, particularly on the child’s affective development.

METHODS

This type of research is descriptive observational, using a literature review method from various articles published in national and international journals. The research article was searched online through Scopus, PubMed, Google Scholar, and Garba Rujukan Digital (Garuda) databases. This method aims to increase knowledge and understanding of the topics discussed by presenting research results published in journals to provide factual information or analysis from relevant literature reviews.

This article review used eight published primary research articles to obtain research data. The literature reviewed was from 2019 to 2024, with the keywords anxiety, pregnancy, maternal, child, and development. The inclusion criteria of this study include original research in Indonesian or English, respondents measuring anxiety during pregnancy, and measurement of infant/child affective patterns, which can be accessed in full. The exclusion criteria are review articles that do not follow the research objectives.

RESULTS

Based on the review of eight articles, anxiety during pregnancy can significantly affect affective disorders in infants/children, as shown in Table 1.

The research is quantitative, based on the review of the eight articles above. It uses a prospective longitudinal study method and a cohort study, which observes respondents at certain times to see their development from pregnancy to infancy/childhood, even preschool.

The respondents in the study were pregnant women up to the babies they had given birth to. Measured from the time of pregnancy, mainly from the second trimester gestational age and some from the first trimester, during labour to 1-8 weeks after delivery and preschool.

Author	Title	Type, Sample, Research Location	Results
Schwarze et al. (2024)2222	The role of perinatal maternal symptoms of depression, anxiety and pregnancy-specific anxiety for infants’ self-regulation: A prospective longitudinal study	Prospective longitudinal study; N = 225 mother-infant dyads in Germany	Anxiety, particularly during a mother’s pregnancy, was the most significant predictor of newborn self-regulation issues. It explained as much as 18% of the variance and predicted crying, sleeping, and feeding issues. Anxiety related to pregnancy was still a strong predictor of newborn self-regulation issues, even after considering the mother’s postpartum emotional symptoms.
Zhang et al. (2023)88	Impact of pregnancy-related anxiety on Preschoolers’ emotional and behavioral development: Gender specificity, critical time windows, and the cumulative effect	Cohort study; N = 1699 mother-infant dyads in China	Preschool-aged children of moms with pregnancy anxiety are far more likely to exhibit aberrant mood or behavior. Compared to males, girls appear to be more susceptible to parental pregnancy anxiety, particularly in terms of emotional disruption. Pregnancy anxiety that occurs in the third trimester of pregnancy has a significant impact on children’s emotional disturbance problems. Children who have emotional disorders and behavioral issues are more likely to be born to mothers who have had anxiety for an extended period throughout their pregnancy.
Rogers et al. (2023)2525	Association of maternal and paternal perinatal depression and anxiety with infant development: A longitudinal study	Longitudinal