Maternal sensitivity moderates the impact of prenatal anxiety disorder on infant responses to the still-face procedure

Animal studies have demonstrated the interactive effects of prenatal stress exposure and postnatal rearing style on offspring capacity to manage stress. However, little is known about how parenting quality impacts the association between maternal prenatal anxiety and stress reactivity in human infants. This prospective study examined the impact of prenatal anxiety disorder and maternal caregiving sensitivity on infants’ responses to a standardised interactive stressor (still-face procedure). Eighty-four women completed a clinical interview during pregnancy to assess anxiety symptoms meeting DSM-IV diagnostic criteria. At infant age 7 months, maternal sensitivity to infant distress and infant negative affect were observed and coded during the still-face procedure. Maternal postnatal (concurrent) anxiety and depression were also assessed at this time. Results indicated a negative association between maternal sensitivity to infant distress and infant negative affect responses to the still-face procedure. An unexpected finding was a positive association between parity and infant reactivity. The main effect for sensitivity was qualified by a significant interaction, p < .05, suggesting that the impact of sensitivity was particularly marked among infants of women who experienced an anxiety disorder during pregnancy. This finding is consistent with a cumulative risk model suggesting that maternal prenatal anxiety and quality of maternal care act in concert to shape infant outcomes.