Objective: To determine whether there are differences in fetal heart rate (FHR) reactivity associated with women's psychiatric status. Method: In 57 women in their 36th to 38th week of pregnancy (mean age 27 [+ or -] 6 years), electrocardiogram, blood pressure (BP), respiration (RSP), and FHR were measured during baseline and a psychological challenge (a Stroop color-word matching task). Subjects underwent the Structured Clinical Interview for DSM-IV (SCID) and completed the Spielberger State-Trait Anxiety Inventory prior to testing. Results: There was a significant main effect of maternal diagnostic group on FHR reactivity during the Stroop task even after controlling for birth weight and women's BP reactivity ([F.sub.4,44] = 2.68, p = .04). Fetuses of depressed women had greater heart rate increases compared to fetuses of women with anxiety disorders and those of healthy, low-anxiety women (post hoc comparisons using the Fisher protected least significant difference test; t = 4.12, p is less than .05; t = 4.72, p is less than .01, respectively). There was a similar pattern comparing fetuses of healthy, high-anxiety women to the same two groups (t = 3.29, p is less than .05; t = 3.99, p is less than .05, respectively). There were no group differences in FHR during a resting baseline period ([F.sub.4,52] = 1.2, p = .35). Conclusions: Maternal mood disturbance is associated with alterations in children's physiological reactivity prior to birth.