Prenatal maternal anxiety and children's brain structure and function: A systematic review of neuroimaging studies

•We reviewed literature on perinatal maternal anxiety and children's brain outcomes.•Ten imaging studies found associations between antenatal anxiety and children's brains.•Alterations were most common in the amygdala, hippocampus, and frontal lobe.•Due to limited studies, interactions with sex and age remain unclear.•More studies with good control of confounding variables and larger samples are needed. Maternal anxiety disorders are common during pregnancy and postpartum, and are associated with increased behaviour problems and risk of mental health difficulties in children. Understanding alterations in brain structure and function associated with maternal anxiety may help elucidate potential mechanisms via which high maternal anxiety could affect children. We conducted a systematic review of extant research studying the associations between prenatal anxiety and children's brain structure and function, as assessed through neuroimaging. Data were gathered in accordance with the PRISMA review guidelines. Ten articles were identified, and all found a significant association between antenatal maternal anxiety and child neurodevelopment. Studies vary considerably in their methods with five studies employing electroencephalography (EEG), one using magnetoencephalography (MEG), and the rest employing magnetic resonance imaging (MRI). The heterogeneity of neuroimaging techniques undertaken by the reviewed studies precluded a meta-analysis from being performed. The applicability of this systematic review to clinical practice is also limited given that the studies examined children across a wide age range (neonates to 17 years). From early infancy to late adolescence, findings suggest alterations of brain structure and function in frontal, temporal, and limbic areas in children born to mothers who experienced prenatal anxiety. These brain abnormalities may underlie associations between prenatal anxiety and children's behaviour, though more research incorporating neuroimaging and behavioural data is necessary to determine this.