Accumulating evidence suggests that psychological distress during pregnancy is linked to offspring risk for externalizing outcomes (e.g., reactive/aggressive behaviors, hyperactivity, and impulsivity). Effect sizes across studies have varied widely, however, due to differences in study design and methodology, including control for the confounding continuation of distress in the postnatal period. Clarifying these inconsistencies is necessary to guide the precision of prevention efforts and inform public health policies. A meta-analysis was conducted with 55 longitudinal studies to investigate the association between prenatal psychological distress (anxiety, depression, and perceived stress) and offspring externalizing behaviors. Results revealed a significant but small effect (r = .160) of prenatal distress on externalizing behaviors. The magnitude of the prenatal effect size remained largely unchanged after adjusting for postnatal distress (r = .159), implicating a unique effect of psychological distress during the prenatal period in the etiology of externalizing behaviors. Moderation tests showed that prenatal effects did not vary based on type and timing of psychological distress during pregnancy. Greater instability of distress from prenatal to postnatal periods predicted larger effects. Prenatal effects were comparable across most externalizing outcomes, consistent with the common comorbidity of externalizing spectrum disorders, although effects appeared smaller for nonaggressive rule-breaking (vs. aggressive) behaviors. Significant associations persisted across all developmental periods, appearing slightly larger in early childhood. We discuss these results in the context of developmental and psychobiological theories of externalizing behavior, offer preliminary clinical and public health implications, and highlight directions for future research including the need for longitudinal studies with more racially and socioeconomically diverse families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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儿童和青少年期的产前压力和外化行为：系统评价和荟萃分析。


越来越多的证据表明，妊娠期的心理困扰与后代外化结局的风险（例如，反应性/攻击性行为、多动和冲动）有关。然而，由于研究设计和方法的差异，包括对产后痛苦持续混杂的控制，研究之间的效应大小差异很大。澄清这些不一致之处对于指导预防工作的精确性并为公共卫生政策提供信息是必要的。对 55 项纵向研究进行了一项荟萃分析，以调查产前心理困扰 （焦虑、抑郁和感知压力） 与后代外化行为之间的关联。结果显示，产前痛苦对外化行为的影响显著但很小 （r = .160）。在调整产后痛苦后，产前效应量的大小基本保持不变 （r = .159），这表明产前心理困扰对外化行为病因的独特影响。适度测试表明，产前影响不因怀孕期间心理困扰的类型和时间而异。从产前到产后痛苦的更大不稳定性预示着更大的影响。大多数外化结局的产前影响相当，与外化谱系障碍的常见合并症一致，尽管对非侵袭性违反规则 （vs. 攻击性） 行为的影响似乎较小。显着的关联在所有发育时期都持续存在，在儿童早期似乎略大。 我们在外化行为的发展和心理生物学理论的背景下讨论了这些结果，提供了初步的临床和公共卫生影响，并强调了未来研究的方向，包括对种族和社会经济更加多样化的家庭进行纵向研究的必要性。（PsycInfo 数据库记录 （c） 2024 APA，保留所有权利）。