Question

Discuss what could be a stressor to a fetus and the possible manifestations

Answer 1

In stressful pregnancy, there will be more amount of adrenaline and cortisol in maternal blood and serotonin will be less. Both adrenaline and cortisol are stress hormones. When they enter into fetal circulation, they go into the limbic system and create a state of unhappiness in the centres which are being set.Increased circulation of adrenaline and cortisol in the blood of foetus leads to a lower electrical activity in the areas of joy, happiness and curiosity. The children who came out of this stressful pregnancy are withdrawn, aggressive in behaviour,violent,disobedient and all other kinds of misbehaviors. When the mother experiences stress, the brain releases is cascade of stress hormones. So in such patients there will be shaking,increased heart rate, dilated pupils and suppressed the immunity. The hypothalamus releases corticotropin releasing hormone (CRH) to the pituitary gland to induce release of adrenocorticotropic hormone ACTH. This hormone travels to reach adrenal cortex to release cortisol into the bloodstream. Cortisol is responsible for breaking down protein, suppressing immunity and inhibiting bone   formation. In the chronic stress cortisol crosses the placenta to reach the fetal circulation. Women exposed to stressful pregnancy will more likely to have preterm delivery and lower birth weight babies. Infants and children who are exposed to special pregnancy is more likely to show emotional problems, hyperactivity and attention deficit. There is also increased risk of infection, reduce brain volume head circumference and reduced IQ.Babies under chronic stress pregnancy will be more prone to cry, restlessness and digestive disorders.Chronic long term stress can affect the brain growth of the baby. Brain cells will be shrink.

The depression in pregnancy have typical symptoms of major depression including:

• Change in sleep patterns
• appetite
• energy
• mood
• capacity to cope with stress
• speed of thinking
• daily thoughts more negative fearful or guilty
• sense of connection to people or roles

Depression during pregnancy can be detected by fatigue,speed of thinking or response and increased intensity or expression of emotion can come with the hormonal and physical changes of pregnancy.But, they should improve with rest and support, not last long and not interfere with the function.
Depression is more likely if:

• the symptoms persist and are getting worse
• the emotions and thinking are increasingly negative
• the experience is not typical for this woman
• the feelings don't fit with their situation

Risk factors of depression in pregnancy are:

• depressive episodes in past
• sensitivity to mood change with hormonal change
• high levels of current stress
• loss of supports
• physical pain and complications in the pregnancy