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Anxiety and neural correlates of attention and self-regulation in pregnancy: a resting-state EEG study

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Abstract

Purpose

Pregnant women are particularly vulnerable to experiencing mental health difficulties, especially anxiety. Anxiety in pregnancy can be characterized as having two components: general symptomology experienced in the general population, and pregnancy-related anxiety more focused on pregnancy, delivery, and the future child. In addition, women also commonly report experiencing attentional control and self-regulation difficulties across the peripartum period. However, links between anxiety and neural and cognitive functioning in pregnancy remain unclear. The present study investigated whether anxiety is associated with neural markers of attention and self-regulation measured using electroencephalography (EEG). Specifically, we examined associations between general and pregnancy-related anxiety and (1) beta oscillations, a neural marker of attentional processing; and (2) the coupling of beta and delta oscillations, a neural marker of self-regulation, in frontal and prefrontal regions.

Methods

A sample of 135 women in the third trimester of their pregnancy completed a resting-state EEG session.

Results

General anxiety was associated with increased beta oscillations, in line with research in the general population, interpreted as reflecting hyperarousal. Pregnancy-related anxiety was associated with decreased beta oscillations, interpreted as reflecting inattention and mind-wandering. Moreover, pregnancy-related anxiety, but not general anxiety, was linked to stronger delta-beta coupling, suggesting anxiety specifically related to the pregnancy is associated with investing greater effort in self-regulation.

Conclusion

Our results suggest that general and pregnancy-related anxiety may differentially relate to neural patterns underlying attention and self-regulation in pregnancy.

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Data availability

Data can be available upon reasonable request and with necessary approvals by contacting the corresponding author.

Notes

  1. The two PRAQ versions differ in one item for first-time expectant mothers versus parous women (“I am anxious about the delivery, because I have never experienced one before” for first-time pregnant women, versus “I am anxious about the delivery” in the version for women who previously gave birth); PRAQ scores were comparable with/without this item (r = .99), and therefore the full scale was retained for analyses.

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Acknowledgements

We would like to thank the women who participated in the studies and Grace Austin, Kelsey Graber, Jonathan Bornstein, and Brianna Francis for data collection and Marion Mayes for data entry. This work was supported by the Anna Freud Centre (UK), the John Leopold Weil and Geraldine Rickard Weil Memorial Charitable Foundation (USA), and the Fundação Bial (Portugal). TY was supported by the Yale Kavli Institute for Neuroscience.

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  1. Josephine C.P. Levy and Tal Yatziv contributed equally to this work.

Authors and Affiliations

  1. Yale Child Study Center, School of Medicine, Yale University, New Haven, CT, USA

    Josephine C.P. Levy, Tal Yatziv, Madison Bunderson, Cody Bartz, Emily A. Vancor & Helena J.V. Rutherford

  2. Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Tal Yatziv

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  1. Josephine C.P. Levy
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Correspondence to Helena J.V. Rutherford.

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Ethical approval was obtained from the Yale University School of Medicine’s Human Investigations Committee. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Levy, J.C., Yatziv, T., Bunderson, M. et al. Anxiety and neural correlates of attention and self-regulation in pregnancy: a resting-state EEG study. Arch Womens Ment Health 28, 43–53 (2025). https://doi.org/10.1007/s00737-024-01505-6

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