LMRJ Volume 2 Issue 3 64 | P a g e Determine the Influence of Prenatal Stress on Fetal Development Anila Sharif1, Hira Saeed2, Maham Siddiqui3, Safila Naveed4, Fatima Qamar5 & Syeda Sarah Abbas6 This article may be cited as: Sharif A., Saeed H., Siddiqui M., Naveed S., Qamar F. & Abbas S.S. determine the influence of prenatal stress on fetal LMRJ. 2020 DOI:10.38106/LMRJ. 2020.2.3-04. Abstract: Prenatal stress is an epigenetic factor which can produce long-lasting alterations in brain structures and body functions. The objective of this was to examine the ratio of prenatal stress among pregnant women. It is necessary to assess stress separately at each trimester of pregnancy to differentiate chronic from acute stress in order to evaluate the effects on child development. Prenatal stress can alter neurotropic growth factors, synapse development, neurotransmitter levels and also adult neuron development. Prenatal stresses significantly influence the development of the brain and the organisation of behaviour. Prenatal stress can also be the main cause of hypertension, type 2 diabetes, schizophrenia and cardiac disorders in adulthood. But the impact of stress is not very clear. The survey based on a cross-sectional study was conducted in Karachi. The sample size calculated for the survey is 45. The pregnant women were asked to fill the questionnaire of 23 questions. Keywords: Prenatal stress, maternal stress, antenatal stress, fetal development & depression. Introduction Prenatal stress (or antenatal maternal stress) is exposure of the associated expectant mother to worry, which might be caused by disagreeable life events or by environmental hardships 1. The ensuing changes in the mother's secretion and the system might hurt the fetuses (and when birth, the infant's) immune perform and brain development 2 Prenatal stress is shown to possess many effects in vertebrate brain development. Within the hippocampus of male rats, antenatal stress has shown to decrease the speed of proliferation and necrobiosis within the hypothalamus-pituitary axis3,4. Antenatal stressed animals have prolonged glucocorticoid response. Removing the adrenal glands of the mother eliminates the impact of the pup's glucocorticoid response. Supplementing the adrenalectomized mother with glucocorticoid, saved the hypothalamic-pituitary-axis response to maternal stress for prenatally stressed offspring5. Antenatal stress caused high glucocorticoids that successively affect the hypothalamic- pituitary-axis feedback 6. A study by García-Cáceres et al. showed that antenatal stress decreases cell turnover and proliferation Research article LMRJ Volume 2 Issue 3 65 | P a g e within the neural structure of adult rats that reduces structural physical property and reduces the response to worry in adulthood 7. This study conjointly showed that once prenatally stressed rats were stressed in adulthood the females showed a rise in corticotrophin-releasing internal secretion suggesting it to be associate up-regulation within the hypothalamic-pituitary adrenal axis8. Males showed no elevation of glucocorticoid levels. Increase in adrenocorticotropic internal secretion adrenocorticotrophic hormone ACTH hormone, endocrine internal secretion} with no impact of adult stress and a decrease within the corticotrophin-releasing hormone ribonucleic acid within the neural structure showed a down-regulation. The author concludes that this makes prenatally stressed females less reactive to later life stressors than males. 9-11 Methodology The cross-sectional study was conducted in Karachi in November 2016, the surveillance study was conducted including pregnant women in the city. The sample size calculated for the survey was 45. A survey questionnaire was developed to address the study questions and was disseminated among the local population. The respondents were asked to answer 23 open- ended questions. According to our estimation, we analyzed that majority of pregnant women are the prey of prenatal stress. Most of them didn’t know about prenatal stress as well as its adverse effects that come in the form of fetal abnormalities. Result According to our report, 40% women feel changes in their behaviour due to prenatal stress and 60% have normal behaviour. Only 40% women during pregnancy feel changes in appetite, 24.4% don’t feel changes in appetite. In our sample size 11.1% suffers environmental stress, 22.2% feels stress due to personal issues and 17.8 % suffers stress due to financial problem. In their relations with family and spouse, only 4.4% have a harsh relation, 11.1% have a good relationship with their family and spouse while others have a normal relation. The stress due to baby’s gender, 51.1% pregnant women have stress about baby's gender from their family. There is a good ratio that 57.8 pregnant women are aware of abnormality of the fetus due to stress. LMRJ Volume 2 Issue 3 66 | P a g e Questions Frequency % Significance Value Do you feel craving towards anything? 53.3 0.467 Do you feel that your sense of smell is increased during pregnancy? 46.7 0.199 Do you feel of being strictly spic and span? 40 0.511 Do you feel of being more forgetful? 42.2 0.557 Do you feel any kind of breathing problems? 46.7 0.15 Do you feel any sort of problem in sleeping? 44.4 0.91 Do you feel of being chronic towards any disease? 22.2 0.596 Do you feel pain in any part of your body? 71.1 0.437 Any sort of pressure you feel from your family? 60 0.258 Do you have pressure about baby’s gender from your in-laws? 51.1 0.776 Do you know that stress during pregnancy can cause abnormality in your child? 57.8 0.792 Discussion According to CharilA et’al 12 reports that maternal mood is affected by stress during pregnancy and the physiology of fetus. As per our reports, we concluded that 40% maternal mood is affected by prenatal stress. In April 1991, a longitudinal study was conducted by T Deaveet’al 13. The report suggests that prenatal stress is the cause of child development abnormality. As per our report, we concluded that 57.8% maternal stress can cause abnormality in child development. Laura Palagini 14 in August 2014 in a review article suggested that insomnia in pregnancy is a determinant of pregnancy outcome. As per our reports, 44.4% suffered from insomnia during pregnancy. Helen Christensen 15 in their reports suggested that pregnancy mothers become forgetful during pregnancy. As per or reports, 42.2% mothers become forgetful due to stress. W. Hofhuis and his team 16 in their research suggested that breathing problems like apnea occurs during pregnancy and also due to maternal smoking. As per our reports, 46.7% pregnant women suffer breathing problems. Matthew W Gillman 17 in his reports showed that chronic diseases can be the cause of prenatal stress. As per or reports, we concluded that 22.2% maternal women are being chronic towards diseases like hypertension, diabetes type 2 and glucose intolerance. According to our reports; 53.3% feel craving towards anything, 71.1% feel pain in the body, 60% feel some sort of pressure from family and 51.1% have pressure about baby’s gender from their in-laws. Conclusion As per our reports, we come up with the conclusion that: Excessive use of abuse material such as alcohol, cocaine, caffeine, or tobacco is one of the major causes of fetus growth retardation. Unhealthy relationships, physical or mental abuse, breakups of the relations or persistent hypertension also play a major role in fetus retardation and in depressed fetal physical or mental growth. By this cross- sectional LMRJ Volume 2 Issue 3 67 | P a g e study, we have tried to aware the majority of women about prenatal stress and its consequences regarding fetal development. To overcome the consequences and inconveniences of prenatal stress, we have to take some healthy and beneficial steps, in order to let the people know about it, awareness programs, seminars, and workshops should be arranged, NGO’s should be run to eliminate the marital abuse from the society, special units should be developed in the rehabilitation centers for pregnant women. References 1. Doberczak, Tatiana M., et al. "Neonatal neurologic and electroencephalographic effects of intrauterine cocaine exposure." The Journal of pediatrics 113.2 (1988): 354-358. 2. Hall, Wayne, and Louisa Degenhardt. "Adverse health effects of non-medical cannabis use." The Lancet 374.9698 (2009): 1383-1391. 3. Koehl, Muriel, et al. "Prenatal stress alters circadian activity of hypothalamo–pituitary–adrenal axis and hippocampal corticosteroid receptors in adult rats of both gender." Developmental Neurobiology 40.3 (1999): 302- 315. 4. Alder, Judith, et al. "Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature." The Journal of Maternal-Fetal & Neonatal Medicine 20.3 (2007): 189-209. 5. Maccari, Stefania, et al. "Prenatal stress and long-term consequences: implications of glucocorticoid hormones." Neuroscience &Biobehavioral Reviews 27.1 (2003): 119-127. 6. Angelidou A, Asadi S, Alysandratos KD, Karagkouni A, Kourembanas S, Theoharides TC. Perinatal stress, brain inflammation and risk of autism-review and proposal. BMC pediatrics. 2012 Dec;12(1):1-2. 7. Kapoor, Amita, et al. "Fetal programming of hypothalamo‐ pituitary‐adrenal function: prenatal stress and glucocorticoids." The Journal of physiology 572.1 (2006): 31-44. 8. Barbazanges, Arnaud, et al. "Maternal glucocorticoid secretion mediates long-term effects of prenatal stress." Journal of Neuroscience 16.12 (1996): 3943- 9. 3949. 10. McCormick CM, Smythe JW, Sharma S, Meaney MJ. Sex- specific effects of prenatal stresson hypothalamic-pituitary-adrenal responses to stress and brain glucocorticoid receptor density in adult rats. Developmental Brain Research. 1995 Jan 14;84(1):55-61. 11. Wright RJ. Perinatal stress and early life programming of lung structure and function. Biological psychology. 2010 Apr 1;84(1):46- 56. 12. Wadhwa, P. D., Sandman, C. A., &Garite, T. J. (2001). The neurobiology of stress in human pregnancy: implications for prematurity and development of the fetal central nervous system. Progress in brain research, 133, 131-142. 13. Charil A, Laplante DP, Vaillancourt C, King S. Prenatal stress and brain development. Brain research reviews. 2010 Oct 5;65(1):56-79. 14. Lemaire V, Koehl M, Le Moal M, Abrous DN. Prenatal stress produces learning deficits associated with an inhibition of neurogenesis in the hippocampus. Proceedings of the National Academy of Sciences. 2000 Sep 26;97(20):11032-7. LMRJ Volume 2 Issue 3 68 | P a g e 15. Palagini L, Gemignani A, Banti S, Manconi M, Mauri M, Riemann D. Chronic sleep loss during pregnancy as a determinant of stress: impact on pregnancy outcome. Sleep medicine. 2014 Aug 1;15(8):853-9. 16. Christensen H, Leach LS, Mackinnon A. Cognition in pregnancy and motherhood: prospective cohort study. The British Journal of Psychiatry. 2010 Feb;196(2):126-32. 17. Hofhuis W. Clinical applications of infant lung function testing. 2004 Jun 10. 18. Gillman MW. Epidemiological challenges in studying the fetal origins of adult chronic disease. International Journal of Epidemiology. 2002 Apr 1;31(2):294-9