Inflammatory bowel diseases (IBDs) are chronic conditions characterised by intestinal and systemic inflammation, often associated with significant psychological distress. Emerging evidence highlights a bidirectional relationship between inflammation and psychological factors, mediated by the gut-brain axis. Psychological distress may not only result from chronic inflammation but also contribute to symptom persistence and disease exacerbation. Despite this, clinical management of IBD primarily focuses on controlling inflammation, often overlooking psychological factors that may influence disease activity and treatment response.

GastroPsy protocol will last for 24 months and will follow a cross-sectional design. At least 150 participants will undergo a clinical evaluation based on the detection of biological, medical and psychological indicators and variables. The evaluation battery will comprise seven validated questionnaires. Through a k-means cluster analysis, the study aims to derive and describe data-driven clusters of IBD patients, finally exploring associations between identified clusters and external clinical variables (e.g. clinical activity).

Ethical Committee Approval was obtained from the CEtRA Abruzzo Region (IT) (Protocol ID 228/2025). The results of the present project will be published in peer-reviewed journals, disseminated electronically and in print, and presented as abstracts and/or personal communications during national and international conferences.

This systematic review aims to examine the association between maternal psychological distress (specifically perceived stress, clinical anxiety and depressive symptoms), measured exclusively during pregnancy, and child neurodevelopmental outcomes assessed within the first 3 years of life (0–36 months), including cognitive, language, socioemotional and behavioural development.

The review was conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered on PROSPERO (CRD42024599742). It focused exclusively on studies assessing maternal distress during the prenatal period and its impact on cognitive, language, socioemotional and behavioural outcomes in infancy and toddlerhood.

A comprehensive search of six databases, PubMed, Web of Science, Cochrane Library, Embase, EBSCOhost and PsycINFO, was conducted up to 10 April 2025, using structured combinations of keywords related to maternal stress and child development.

: Studies were included if they assessed psychological distress during pregnancy with validated tools and evaluated neurodevelopmental outcomes in children aged 0–36 months using standardised measures. Excluded were studies measuring distress only postnatally, animal models, non-original articles and studies without neurodevelopmental endpoints.

Data were extracted and reviewed independently by two authors using predefined criteria, with a third reviewer resolving disagreements. Methodological quality was assessed using the Cochrane Risk of Bias in Non-randomised Studies of Exposures tool for non-randomised studies and Cohort Studies. Given study heterogeneity, a structured narrative synthesis with standardised effect summaries was used.

44 studies met the inclusion criteria. Across these, small, correlational associations linked higher maternal distress during pregnancy with modest differences in cognitive and language scores and with elevated risks of behavioural and socioemotional difficulties. Children exposed to higher distress more often showed attention problems, greater negative emotionality, lower verbal ability and weaker emotion regulation, with effects frequently attenuated after adjustment and selective attrition.

Maternal psychological distress during pregnancy is a context-sensitive correlate, not a proven cause, of early neurodevelopmental differences across cognitive, emotional and behavioural domains.