|
== Hormonal influence ==
A delicate balance of hormones during pregnancy is regarded as being highly relevant to fetal programming and may significantly influence offspringthe outcomesoutcome on the offspring.<ref name="Hoffman_2016">{{cite journal | vauthors = Hoffman MC | title = Stress, the Placenta, and Fetal Programming of Behavior: Genes' First Encounter With the Environment | journal = The American Journal of Psychiatry | volume = 173 | issue = 7 | pages = 655–7 | date = July 2016 | pmid = 27363547 | doi = 10.1176/appi.ajp.2016.16050502 }}</ref> Placental endocrine transfer from the mother to the developing fetus could be altered by the mental state of the mother, due to affected [[glucocorticoid]] transfer that takes place across the placenta.<ref name="Hoffman_2016" />
=== Thyroid ===
Thyroid hormones play an instrumental role during the early development of the fetus's brain. Therefore, mothers suffering from thyroid-related issues and the resultant altered thyroid hormone levels may inadvertently trigger structural and functional changes in the fetal brain. The fetus is able to produce its own thyroid hormones from the onset of the second trimester; however, maternal thyroid hormones are important for brain development before and after the baby is able to synthesize the hormones while still in the uterus.<ref name="Andersen_2016">{{cite journal | vauthors = Andersen SL, Olsen J, Laurberg P | title = Foetal programming by maternal thyroid disease | journal = Clinical Endocrinology | volume = 83 | issue = 6 | pages = 751–8 | date = December 2015 | pmid = 25682985 | doi = 10.1111/cen.12744 }}</ref> Due to this, the baby may experience increased risk of neurological or psychiatric diseasediseases later in life.<ref name="Andersen_2016" />
=== Mental state ===
Mental state of the mother during pregnancy affects the fetus in the uterus, predominantly via hormones and genetics.<ref name="Suter_2013">{{cite journal | vauthors = Suter MA, Anders AM, Aagaard KM | title = Maternal smoking as a model for environmental epigenetic changes affecting birthweight and fetal programming | journal = Molecular Human Reproduction | volume = 19 | issue = 1 | pages = 1–6 | date = January 2013 | pmid = 23139402 | pmc = 3521486 | doi = 10.1093/molehr/gas050 }}</ref> The mother's mood, including maternal prenatal anxiety, depression and stress during pregnancy correlates with altered outcomes for the child.<ref name="Suter_2013" /> AlthoughThat being said, not every fetus exposed to these factors is affected in the same way and to the same degree, and genetic and environmental factors are believed to have a significant degree of influence.<ref name="Suter_2013" />
==== Depression ====
Maternal depression isposes one of the greatest risks for increased vulnerability to adverse outcomes for a baby that is developing in the uterus, especially in terms of susceptibility to a variety of psychological conditions.<ref name="Davis_2018">{{cite journal | vauthors = Davis EP, Hankin BL, Swales DA, Hoffman MC | title = An experimental test of the fetal programming hypothesis: Can we reduce child ontogenetic vulnerability to psychopathology by decreasing maternal depression? | journal = Development and Psychopathology | volume = 30 | issue = 3 | pages = 787–806 | date = August 2018 | pmid = 30068416 | doi = 10.1017/S0954579418000470 }}</ref> Mechanisms that may explain the connection between maternal depression and the offspring's future health are mostly unclear and form a current area of active research.<ref name="Davis_2018" /> Genetic inheritance makingthat may be rendering the child more susceptible may play a role, including the effect on the intrauterine environment for the baby whilst the mother suffers from depression.<ref name="Davis_2018" />
==== Stress ====
Stress suffered by the mother during pregnancy can have an adverse affect on the developing baby, and can manifest in form of early labour, low birth weight and can also induce a risk for psychiatric complications later in life.<ref name="Hoffman_2016" /> The new mother suffers from after-effects too, such as postpartum depression, and subsequently may find parenting more difficult as compared to those who did not experience as much stress during their pregnancypregnancies.<ref name="Hoffman_2016" />
== Toxins ==
Toxins such as alcohol, tobacco and certain drugs exposed to which the baby is exposed to during theirits development are thought to contribute to fetal programming, especially via alterations to the HPA axis.<ref name="Bekdash_2014">{{cite journal | vauthors = Bekdash R, Zhang C, Sarkar D | title = Fetal alcohol programming of hypothalamic proopiomelanocortin system by epigenetic mechanisms and later life vulnerability to stress | journal = Alcoholism, Clinical and Experimental Research | volume = 38 | issue = 9 | pages = 2323–30 | date = September 2014 | pmid = 25069392 | pmc = 4177357 | doi = 10.1111/acer.12497 }}</ref> EspeciallyIf ifthe exposedexposure tooccurs during a critical window of fetal development, thisit iscould thoughtimply todrastic exertand mostdire consequenceconsequences for the fetus.<ref name="Bekdash_2014" />
=== Alcohol ===
Prenatal and/or early postnatal exposure to alcohol (ethanol) has been found to exert negative effects on child's neuroendocrine and behavioral factors.<ref name="Weinberg_2008">{{cite journal | vauthors = Weinberg J, Sliwowska JH, Lan N, Hellemans KG | title = Prenatal alcohol exposure: foetal programming, the hypothalamic-pituitary-adrenal axis and sex differences in outcome | journal = Journal of Neuroendocrinology | volume = 20 | issue = 4 | pages = 470–88 | date = April 2008 | pmid = 18266938 | doi = 10.1111/j.1365-2826.2008.01669.x }}</ref> Alcohol passes through the placenta, throughon ingestionbeing ingested by the mother during her pregnancy, and ismakes accessedits byway to the baby in uterouterus.<ref name="Weinberg_2008" /> the changes posed to the fetus by ethanol exposure may significantly effect growth and development; these disorders constitute fetal alcohol spectrum disorders (FASD).<ref name="Weinberg_2008" /> The exact interactionsinteraction between ethanol and the developing fetus areis complex and largely uncertain, however, there are thought to be both direct and indirect effects onas athe developing baby as itfetus developsmatures.<ref name="Weinberg_2008" /> Predominant effects are thought to be the fetus's endocrine, metabolic and physiological functions.<ref name="Weinberg_2008" />
=== Smoking ===
The negative consequences of [[smoking]] are well-known, although the consequencesthese may be even more apparent during pregnancy.<ref name="Suter_2013" /> Exposure to tobacco smoke during pregnancy, commonly known as ''in utero'' maternal tobacco smoke exposure (MTSE), can contribute totowards thevarious differentproblems response ofin babies of smoking mothers.<ref name="Suter_2013" /> About 20% of mothers smoke whilst pregnant and this is associated with increased risk of complications, for example, preterm birth, decreased fetal growth leading to decreasedlower birth weight, and impaired lung development of the baby whilst they develop in the womb.<ref name="Suter_2013" />
=== Drugs ===
There is evidence forpointing towards pharmacological programming during the first trimester:, namely fetal programming.<ref name="Bayliss_2002">{{cite journal | vauthors = Bayliss H, Churchill D, Beevers M, Beevers DG | title = Anti-hypertensive drugs in pregnancy and fetal growth: evidence for "pharmacological programming" in the first trimester? | journal = Hypertension in Pregnancy | volume = 21 | issue = 2 | pages = 161–74 | date = January 2002 | pmid = 12175444 | doi = 10.1081/prg-120013785 }}</ref> One such drug type which is suspected toof influenceinfluencing the developing baby areis the anti-hypertensive drugscategory used during pregnancy.<ref name="Bayliss_2002" /> Pre-eclampsia (a conditionalcondition of hypertension during pregnancy), is a serious problemsproblem for proportionmajority of pregnant mothers and can predispose the mother to a variety youof complications, including increased risk of mortality and problems during parturition.<ref name="Bayliss_2002" />
== References ==
|
