Long-term cognitive sequelae of antenatal maternal anxiety: involvement of the orbitofrontal cortex.

Anxiety and stress experienced by the mother during pregnancy are reported to have a negative association with the cognitive development of the child. An integration of recent evidence from cognitive reaction time tasks pointed to a deficit in endogenous response inhibition, a function ascribed to prefrontal cortex. To further delineate the cognitive sequelae associated with antenatal maternal anxiety, we reviewed recent neuro-imaging literature to create a cortical map of regions commonly and selectively activated by well-known cognitive tasks. The pragmatic value of this cortical map was tested in a follow-up sample of 49 17-year old adolescents. Adolescents of mothers with high levels of anxiety during week 12-22 of their pregnancy performed significantly lower in tasks which required integration and control of different task parameters. Working memory, inhibition of a prepotent response, and visual orienting of attention were not impaired. Based on the established cortical map, these results were related to subtle developmental aberrations in a part of, or in cortical and sub-cortical regions linked to, the orbitofrontal cortex.