Association between Maternal Anxiety and Children’s Problem Behaviors: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
1.1. Maternal Anxiety
1.2. Problem Behaviors of Preschool Children
1.3. The Relationship between Maternal Anxiety and Preschool Children’s Problem Behaviors
2. Materials and Methods
2.1. Literature Search
2.2. Criteria for Literature Inclusion
2.3. Coding
2.4. Meta-Analytic Process
2.4.1. Effect Sizes
2.4.2. Model Selection
2.4.3. Publication Bias
Main Author | Year | Region | Sample Size | Age of Children | Gender (Male %) | Maternal Age | Maternal Education | Period | Variable Type | Correlation Coefficient |
---|---|---|---|---|---|---|---|---|---|---|
Ali [29] | 2019 | Americas | 182 | T | <50% | 30~35 | 60~80% | N | E | 0.300 |
Ali [29] | 2019 | Americas | 182 | T | <50% | 30~35 | 60~80% | N | I | 0.350 |
Arikan [30] | 2021 | Asia | 537 | T | 50~65% | 30~35 | <60% | N | I | 0.510 |
Arikan [30] | 2021 | Asia | 537 | T | 50~65% | 30~35 | <60% | N | E | 0.500 |
Antúnez [22] | 2018 | Europe | 311 | T | <50% | Not reported | Not reported | N | P | 0.130 |
Bangirana [31] | 2021 | Africa | 116 | T | <50% | Not reported | <60% | N | P | 0.163 |
Clavarino [32] | 2009 | Australia | 428 | C | 50~65% | <30 | >80% | N | E | 0.220 |
Clavarino [32] | 2009 | Australia | 400 | C | 50~65% | <30 | >80% | N | E | 0.238 |
Clavarino [32] | 2009 | Australia | 365 | C | 50~65% | <30 | >80% | N | E | 0.261 |
Clavarino [32] | 2009 | Australia | 608 | C | 50~65% | 30~35 | >80% | N | E | 0.204 |
Clavarino [32] | 2009 | Australia | 298 | C | 50~65% | 30~35 | >80% | N | E | 0.237 |
Clavarino [32] | 2009 | Australia | 387 | C | 50~65% | 30~35 | >80% | N | E | 0.256 |
Clavarino [32] | 2009 | Australia | 332 | C | 50~65% | 30~35 | >80% | N | E | 0.278 |
Ning [33] | 2021 | Asia | 12657 | Not reported | 50~65% | Not reported | Not reported | N | P | 0.112 |
Di Stefano [34] | 2014 | Americas | 993 | Not reported | 50~65% | Not reported | Not reported | N | E | 0.120 |
Di Stefano [34] | 2014 | Americas | 993 | Not reported | 50~65% | Not reported | Not reported | N | I | 0.270 |
Frigerio [35] | 2021 | Europe | 90 | T | 50~65% | 30~35 | Not reported | N | I | 0.470 |
Frigerio [35] | 2021 | Europe | 90 | T | 50~65% | 30~35 | Not reported | N | I | 0.520 |
Frigerio [35] | 2021 | Europe | 90 | T | 50~65% | 30~35 | Not reported | N | I | 0.380 |
Frigerio [35] | 2021 | Europe | 90 | T | 50~65% | 30~35 | Not reported | N | I | 0.460 |
Frigerio [35] | 2021 | Europe | 90 | T | 50~65% | 30~35 | Not reported | N | E | 0.250 |
Frigerio [35] | 2021 | Europe | 90 | T | 50~65% | 30~35 | Not reported | N | E | 0.310 |
Frigerio [35] | 2021 | Europe | 90 | T | 50~65% | 30~35 | Not reported | N | E | 0.330 |
Frigerio [35] | 2021 | Europe | 90 | T | 50~65% | 30~35 | Not reported | N | E | 0.400 |
Frigerio [36] | 2022 | Europe | 94 | T | 50~65% | 30~35 | >80% | E | I | 0.275 |
Frigerio [36] | 2022 | Europe | 88 | T | 50~65% | >35 | >80% | E | I | 0.115 |
Frigerio [36] | 2022 | Europe | 59 | C | 50~65% | >35 | >80% | E | I | 0.480 |
Frigerio [36] | 2022 | Europe | 94 | T | 50~65% | 30~35 | >80% | E | E | 0.285 |
Frigerio [36] | 2022 | Europe | 88 | T | 50~65% | >35 | >80% | E | E | 0.130 |
Frigerio [36] | 2022 | Europe | 59 | C | 50~65% | >35 | >80% | E | E | 0.365 |
Gagne [37] | 2019 | Americas | 198 | T | 50~65% | Not reported | Not reported | N | E | 0.160 |
Gagne [37] | 2019 | Americas | 198 | T | 50~65% | Not reported | Not reported | N | E | 0.230 |
Gagne [37] | 2019 | Americas | 1994 | C | Not reported | 30~35 | >80% | N | I | 0.220 |
Gagne [37] | 2019 | Americas | 1994 | C | Not reported | 30~35 | >80% | N | E | 0.230 |
Zilin [15] | 2019 | Asia | 71 | C | >65% | Not reported | Not reported | N | P | 0.544 |
Gjerde [38] | 2020 | Europe | 40457 | T | 50~65% | Not reported | Not reported | N | I | 0.150 |
Gjerde [38] | 2020 | Europe | 40457 | T | 50~65% | Not reported | Not reported | N | I | 0.140 |
Gjerde [38] | 2020 | Europe | 40457 | T | 50~65% | Not reported | Not reported | N | I | 0.170 |
Gjerde [38] | 2020 | Europe | 40457 | T | 50~65% | Not reported | Not reported | N | E | 0.110 |
Gjerde [38] | 2020 | Europe | 40457 | T | 50~65% | Not reported | Not reported | N | E | 0.110 |
Gjerde [38] | 2020 | Europe | 40457 | T | 50~65% | Not reported | Not reported | N | E | 0.150 |
HanetzGamliel [39] | 2021 | Asia | 141 | C | <50% | >35 | <60% | E | E | 0.260 |
HanetzGamliel [39] | 2021 | Asia | 141 | C | <50% | >35 | <60% | E | I | 0.370 |
Hautmann [40] | 2014 | Europe | 106 | C | >65% | 30~35 | Not reported | N | E | 0.340 |
Hautmann [40] | 2014 | Europe | 106 | C | >65% | 30~35 | Not reported | N | E | 0.360 |
Hautmann [40] | 2014 | Europe | 106 | C | >65% | 30~35 | Not reported | N | E | 0.400 |
Loomans [41] | 2011 | Europe | 3446 | C | 50~65% | 30~35 | <60% | N | P | 0.280 |
Marceau [42] | 2015 | Americas | 308 | Not reported | 50~65% | Not reported | Not reported | N | E | 0.020 |
Marceau [42] | 2015 | Americas | 308 | Not reported | 50~65% | Not reported | Not reported | N | E | 0.080 |
Marceau [42] | 2015 | Americas | 308 | Not reported | 50~65% | Not reported | Not reported | N | I | -0.003 |
Marceau [42] | 2015 | Americas | 308 | Not reported | 50~65% | Not reported | Not reported | N | I | 0.080 |
McFarlane [43] | 2014 | Americas | 300 | C | Not reported | 30~35 | Not reported | N | I | 0.611 |
McFarlane [43] | 2014 | Americas | 300 | C | Not reported | 30~35 | Not reported | N | E | 0.494 |
McFarlane [43] | 2014 | Americas | 300 | C | Not reported | 30~35 | Not reported | N | P | 0.666 |
Mount [23] | 2010 | Americas | 83 | T | >65% | 30~35 | Not reported | N | I | 0.110 |
Porter [44] | 2019 | Australia | 191 | T | Not reported | <30 | 60~80% | N | P | 0.300 |
Porter [44] | 2019 | Australia | 191 | T | Not reported | <30 | 60~80% | N | P | 0.180 |
Porter [44] | 2019 | Australia | 191 | T | Not reported | 30~35 | 60~80% | N | P | 0.280 |
Porter [44] | 2019 | Australia | 191 | T | Not reported | 30~35 | 60~80% | N | P | 0.350 |
Ying [2] | 2019 | Asia | 335 | C | 50~65% | 30~35 | <60% | N | E | 0.320 |
Ying [2] | 2019 | Asia | 335 | C | 50~65% | 30~35 | <60% | N | E | 0.140 |
Huihui [45] | 2016 | Asia | 3653 | Not reported | 50~65% | Not reported | <60% | N | P | 0.078 |
Huihui [45] | 2016 | Asia | 3375 | Not reported | 50~65% | Not reported | <60% | N | P | 0.091 |
Teramoto [46] | 2005 | Asia | 670 | T | Not reported | Not reported | Not reported | N | P | 0.400 |
Teramoto [46] | 2005 | Asia | 670 | T | Not reported | Not reported | Not reported | N | E | 0.400 |
Teramoto [46] | 2005 | Asia | 670 | T | Not reported | Not reported | Not reported | N | I | 0.330 |
Thorsteinsdottir [47] | 2018 | Europe | 623 | C | <50% | >35 | 60~80% | N | P | 0.562 |
Tichelman [48] | 2021 | Europe | 1528 | Not reported | Not reported | 30~35 | <60% | N | E | 0.247 |
Tichelman [48] | 2021 | Europe | 1528 | Not reported | Not reported | 30~35 | <60% | N | I | 0.214 |
wai [49] | 2017 | Asia | 61 | T | <50% | 30~35 | Not reported | N | I | 0.670 |
wai [49] | 2017 | Asia | 61 | T | <50% | 30~35 | Not reported | N | E | 0.520 |
Yueyuan [50] | 2020 | Asia | 506 | C | 50~65% | Not reported | <60% | N | I | 0.208 |
Wiggins [51] | 2019 | Americas | 672 | Not reported | >65% | 30~35 | >80% | N | P | 0.127 |
Yoldaş [52] | 2019 | Asia | 40 | T | <50% | 30~35 | <60% | N | I | 0.430 |
Yoldaş [52] | 2019 | Asia | 40 | T | <50% | 30~35 | <60% | N | E | 0.512 |
Yoldaş [52] | 2019 | Asia | 40 | T | <50% | 30~35 | <60% | N | P | 0.488 |
Yoldaş [52] | 2019 | Asia | 40 | T | <50% | 30~35 | 60~80% | N | I | 0.412 |
Yoldaş [52] | 2019 | Asia | 40 | T | <50% | 30~35 | 60~80% | N | I | 0.403 |
Yurdusen [53] | 2013 | Asia | 204 | C | 50~65% | 30~35 | 60~80% | N | I | 0.420 |
Yurdusen [53] | 2013 | Asia | 204 | C | 50~65% | 30~35 | 60~80% | N | E | 0.330 |
Yurdusen [53] | 2013 | Asia | 204 | C | 50~65% | 30~35 | 60~80% | N | P | 0.430 |
Yan [54] | 2011 | Asia | 308 | Not reported | <50% | Not reported | 60~80% | N | I | 0.418 |
Zhang [55] | 2022 | Americas | 831 | T | 50~65% | <30 | Not reported | N | P | 0.280 |
Hao [56] | 2021 | Asia | 3097 | Not reported | 50~65% | Not reported | <60% | E | P | 0.278 |
Yang [57] | 2014 | Asia | 355 | Not reported | 50~65% | Not reported | 60~80% | N | I | 0.351 |
Zlomke [24] | 2020 | Americas | 64 | C | >65% | 30~35 | 60~80% | N | P | 0.045 |
Zlomke [24] | 2020 | Americas | 64 | C | >65% | 30~35 | 60~80% | N | P | 0.153 |
Zlomke [24] | 2020 | Americas | 64 | C | >65% | 30~35 | 60~80% | N | P | 0.097 |
3. Results
3.1. Heterogeneity Test
3.2. Publication Bias Test
3.3. Main Effect Analysis
3.4. Moderation Effect Test
4. Discussion
4.1. Maternal Anxiety and Preschool Children’s Problem Behaviors
4.2. Influencing Factors
4.2.1. Cultural Background
4.2.2. Age and Gender of Children
4.2.3. Mother’s Age and Education Level
4.3. Limitations and Future Research
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Outcome | Q | df | p | I2 | σ2 |
---|---|---|---|---|---|
Problem Behavior | 1452.493 | 87 | <0.001 | 94.010 | 0.005 |
Outcome | Rosenthal’s N | Egger’s Intercept | SE | LL | UL | p |
---|---|---|---|---|---|---|
Problem Behavior | 6737 | 2.94487 | 0.41627 | 2.11736 | 3.77238 | <0.001 |
Outcome | N | k | r | LL | UL | z | p |
---|---|---|---|---|---|---|---|
Problem Behavior | 295,032 | 88 | 0.273 | 0.255 | 0.292 | 27.277 | <0.001 |
Outcome Variable | Regulated Variable | Category | k | r | LL | UL | Qb | p |
---|---|---|---|---|---|---|---|---|
Problem Behavior | Region | Americas | 21 | 0.239 | 0.167 | 0.309 | 15.551 | 0.004 |
Asia | 27 | 0.356 | 0.297 | 0.411 | ||||
Europe | 28 | 0.230 | 0.205 | 0.254 | ||||
Australia | 11 | 0.247 | 0.205 | 0.254 | ||||
Africa | 1 | 0.163 | -0.020 | 0.335 | ||||
Age of Children | Child | 31 | 0.333 | 0.282 | 0.382 | 4.957 | 0.026 | |
Toddler | 42 | 0.270 | 0.246 | 0.293 | ||||
Gender (Male%) | <50% | 15 | 0.398 | 0.303 | 0.484 | 12.522 | 0.002 | |
50~65% | 50 | 0.220 | 0.201 | 0.239 | ||||
>65% | 9 | 0.250 | 0.135 | 0.358 | ||||
Maternal Age | >35 | 7 | 0.340 | 0.173 | 0.488 | 11.713 | 0.003 | |
30~35 | 48 | 0.348 | 0.308 | 0.387 | ||||
<30 | 6 | 0.253 | 0.216 | 0.291 | ||||
Maternal Education | <60% | 17 | 0.285 | 0.219 | 0.348 | 10.124 | 0.006 | |
60~80% | 17 | 0.334 | 0.265 | 0.400 | ||||
>80% | 16 | 0.225 | 0.199 | 0.250 | ||||
Period | Non-epidemic period | 79 | 0.272 | 0.253 | 0.291 | 0.081 | 0.776 | |
Epidemic period | 9 | 0.280 | 0.229 | 0.330 |
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Song, Z.; Huang, J.; Qiao, T.; Yan, J.; Zhang, X.; Lu, D. Association between Maternal Anxiety and Children’s Problem Behaviors: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2022, 19, 11106. https://doi.org/10.3390/ijerph191711106
Song Z, Huang J, Qiao T, Yan J, Zhang X, Lu D. Association between Maternal Anxiety and Children’s Problem Behaviors: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2022; 19(17):11106. https://doi.org/10.3390/ijerph191711106
Chicago/Turabian StyleSong, Zhanmei, Jie Huang, Tianqi Qiao, Jingfeng Yan, Xueying Zhang, and Dengcheng Lu. 2022. "Association between Maternal Anxiety and Children’s Problem Behaviors: A Systematic Review and Meta-Analysis" International Journal of Environmental Research and Public Health 19, no. 17: 11106. https://doi.org/10.3390/ijerph191711106