Maternal antenatal psychological distress can negatively affect child development, particularly in low- and middle-income countries (LMICs) where women are at heightened risk for distress. This study examined the association between maternal antenatal distress and child amygdala-prefrontal cortex functional connectivity in a South African birth cohort using resting-state fMRI. Children aged 2-3 years who were either exposed to maternal distress in utero ( n =27) or unexposed ( n =85) were analyzed using region-of-interest analysis. Multivariate analysis of covariance assessed group differences, adjusting for confounders, and Pearson correlations examined associations with externalizing behaviors 6-18 months later across the whole sample ( n =111). Exposed children showed weaker amygdala-medial PFC and amygdala-lateral PFC connectivity than unexposed peers (medial PFC: mean=0.099 vs 0.164, p =0.034; lateral PFC: mean=0.095 vs 0.132, p =0.025). These differences were significant in boys only (medial PFC: p =0.016; lateral PFC: p =0.019). Additionally, hippocampus-PFC connectivity at ages 2-3 was negatively associated with later externalizing behaviors. Findings suggest exposure to maternal psychological distress in utero impacts amygdala-PFC connectivity in early childhood, while exploratory associations between hippocampus-PFC and externalizing behavior point to potential links with later behavioral outcomes. Understanding these neural correlates may inform early interventions to disrupt intergenerational transmission of psychological risk. • Antenatal maternal psychological distress can negatively affect child development • Pregnant women in LMICs are particularly vulnerable to experiencing distress • Maternal distress impacts child amygdala-prefrontal cortex functional connectivity • Need targeted interventions in LMICs to support maternal antenatal mental health
Miles et al. (Sun,) studied this question.