Psychological distress during pregnancy is common among mothers carrying fetuses with congenital heart disease and may affect early child development. This study published in Pediatric Research assessed whether prenatal maternal psychological distress is associated with neurodevelopmental outcomes in toddlers with congenital heart disease (CHD).

Pregnant women carrying fetuses with CHD were recruited between 21 and 39 gestational weeks. Maternal psychological distress was assessed using validated tools, including the Spielberger State-Trait Anxiety Inventory, Perceived Stress Scale, and Edinburgh Postnatal Depression Scale. Neurodevelopment at 18 months was evaluated using the Bayley Scales of Infant and Toddler Development III and the Infant-Toddler Social and Emotional Assessment. Postnatal parenting stress was measured using the Parenting Stress Index–Short Form.

A total of 123 pregnant women were included. Screening identified elevated anxiety in about half of participants, elevated stress in 60%, and depressive symptoms in 34%. Higher levels of prenatal maternal distress were associated with lower motor development scores and greater externalizing behaviors among toddlers with CHD. Associations were stronger among children with single-ventricle CHD compared with two-ventricle CHD. Elevated prenatal distress was also associated with higher postnatal parenting stress at 18 months, including increased Total Stress, Parental Distress, and Difficult Child scores. Postnatal parenting stress mediated associations between prenatal distress and toddler externalizing behaviors.

Prenatal maternal psychological distress was associated with motor and behavioral outcomes in toddlers with CHD. Postnatal parenting stress was identified as a mediator between prenatal maternal distress and toddler externalizing behaviors.