Does maternal anxiety affect neonatal behaviour differently in boys and girls?
Introduction
Several studies have shown that the emotional states of pregnant women affect gestational age at birth, infant prenatal development (infant birth weight, cranial perimeter at birth) and neonatal behaviour [1], [2], [3]. Maternal anxiety levels have been related to poor motor maturation in infants, instability of the autonomic nervous system (ANS), poor orientation and poor self-regulation assessed using the Neonatal Behavioural Assessment Scale (NBAS) [4], [5], [6], [7]. However, few authors have studied gender differences in neonatal behaviour and whether maternal emotional states influence the prenatal development of boys and girls differently. Boatella-Costa et al. [8] found some gender differences in neonatal behaviour: girls showed better orientation to face and human voice and better alertness than boys. Likewise, Lundqvist and Sabel [9] observed that girls showed higher levels of functioning than boys. Canals et al. [10] found no differences between gender in the Neonatal Behaviour Assessment Scale (NBAS) clusters but did find differences in the development of behaviour during the first month of life. Later in childhood and adulthood, there is strong evidence that some aspects of behaviour differ in boys and girls, which the authors attribute to the gonadal hormonal influence during the prenatal and postnatal brain development period [11], [12], [13]. During pregnancy, levels of testosterone influence sexual brain differentiation, and levels of this hormone are higher in male foetuses than in female foetuses. Moreover, maternal anxiety and stress precipitate the release of catecholamines and cortisol, resulting in the vasoconstriction of maternal blood vessels, a diminished blood flow to the foetus, and the consequent restriction of oxygen and nutrients, which in turn might interfere with the adequate development of the central nervous system (CNS) [14]. We hypothesise that maternal emotional states affect prenatal development and neonatal behaviour differently in boys and girls. The aim of this study is to investigate gender differences in neonatal behaviour according to maternal anxiety.
Section snippets
Sample
259 (128 boys and 131 girls) healthy full-term newborns at 48–72 h of life and their mothers participated in this study. The mothers' mean age was 31.43 (SD = 5.46). The mean gestational age was 39.27 weeks (SD = 1.36) and the mean birth weight was 3217.9 g (SD = 404.34). 163 were normal deliveries (62.9%) and 201 mothers did not smoke during pregnancy (77.6%). None of the children had medical problems in the immediate postpartum period.
Instruments
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State Trait Anxiety Inventory (STAI) [15]: This self-questionnaire
Results
Our results show that in boys higher levels of maternal anxiety are related to lower state organization (t = 3.249; p = 0.002) and to better autonomic response (t = − 2.024; p = 0.045). In girls, we did not find differences in behaviour according to maternal anxiety.
Table 1 shows the significant regression models. Only in boys was Trait Anxiety related to a worse neonatal state organization response, with better autonomic stability and with a worse global impression of the examiner.
Discussion
The data support the hypothesis that maternal anxiety affects neonatal behaviour differently in boys and girls. We have found that maternal anxiety is related to poor neonate state organization and increased autonomic stability in boys, but not in girls; moreover, the neonate's global impression of the examiner (a supplementary item of the NBAS) was found to be worse in boys whose mothers had higher anxiety levels. These results are relevant because in our study levels of maternal anxiety were
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