Maternal Anxiety During Pregnancy and Predictive Processing Across Development: A Cross-Cohort Empirical Reappraisal

Abstract

Prenatal maternal distress has been linked to differences in offspring brain and behavioural development, but is rarely framed computationally. Predictive-processing (PP) accounts hold that perception, cognition, and action arise from the interplay of incoming input and internally generated predictions, governed in part by precision. We reappraised eleven publications from two non-clinical prenatal cohorts for a coherent PP-compatible developmental pattern. Eight Leuven publications spanned adolescence to adulthood: externally cued response inhibition was largely preserved, whereas differences emerged when task goals, stimulus relevance, expected outcomes, and response policies had to be generated or maintained endogenously. At age 28, higher prenatal anxiety was associated with lower radial and mean diffusivity in the left superior posterior corona radiata, lower Vocabulary scores, weaker medial prefrontal to left inferior frontal connectivity, and greater unpleasantness of induced dyspnoea. Three Tilburg ERP publications covered infancy and early childhood: higher prenatal anxiety was associated with increased processing of repeated standard tones, of fearful over happy vocalizations, and of neutral over pleasant or unpleasant pictures. Maternal mindfulness, the only positive prenatal characteristic examined, showed the opposite association for the repeated standard, suggesting that positive and distress-related states may act differently on shared mechanisms. Across cohorts, findings were compatible with differences in how relevance and processing resources are allocated to predictable, threat-related, ambiguous, contextual, feedback-related, and bodily information. Because these publications did not formally estimate precision, prediction errors, or priors, we treat them as hypothesis-supporting rather than a formal test of the account.