Children whose mothers were highly stressed or depressed during pregnancy may be at greater risk for mental health and behavioral problems during childhood and adolescence, according to research published by the American Psychological Association in the journal Psychological Bulletin’.

The researchers analyzed data from 55 studies with more than 45,000 participants total participants. All studies measured women’s psychological distress during pregnancy, including stress, depression or anxiety. They then measured their children’s mental health symptoms, such as attention deficit hyperactivity disorder (ADHD) or aggression.

The researchers found that women who reported more anxiety, depression or stress during pregnancy they were more likely to have children with more ADHD symptoms or who exhibited aggressive or hostile behavior. The result was true regardless of whether the children were boys or girls and was also true for children of all ages: early childhood (2-5 years), middle childhood (6-12 years) and adolescence (13- 18 years old). However, the effect was stronger in early childhood.

According to the researchers, the findings are consistent with theories that exposure to stress hormones in the womb can affect children’s brain development.

“These findings add to the evidence that providing widely accessible mental health care and support during pregnancy may be a critical step in preventing childhood behavioral problems,” notes study author Irene Tung of California State University Dominguez Hills.