Fetal Neurobehavioral Development: The Role of Maternal Psychosocial, Pathological, and Pharmacological Stress

Abstract

Maternal-fetal stressors during the gestational period, such as psychosocial stress, disease burden, and medication use, have been shown to significantly affect the neurological and biological development of the fetus. To our knowledge, no previous study in the literature has synthesized the role of these various stressors in neurodevelopment into a single concise review article. Maternal psychosocial stress has been shown to raise levels of stress hormones, such as corticotropin-releasing hormone and adrenocorticotropic hormone, which in turn signal the release of glucocorticoids (eg, cortisol) along with catecholamines in the mother and fetus. These cascades could potentially have significant effects on fetal neurodevelopment. Further, this article highlights that certain maternal infectious disease states, such as influenza and Toxoplasma gondii, are associated with increased risk of psychiatric disorders among offspring, including schizophrenia and neurocognitive delay. Investigators have also found that antibodies from autoimmune disease have direct neurotoxic effects on neural cell receptors, manifesting in future cognitive performance deficits. Additionally, we note that the effects of opioid analgesics on fetal neurodevelopment are not well elucidated but some existing literature has found increased rates of neural tube defects and delays in central nervous system development. In summary, there is a need for increased prenatal screening for a wide breadth of maternal stressors to mitigate negative effects on fetal neurodevelopment.