Stress (prenatal and perinatal)

Topic Editor: Vivette Glover, MA, PhD, DSc, Imperial College London, United Kingdom  

More research is clearly needed in this area. We need to know more about the relative contributions of prenatal stress, postnatal care and genetic vulnerabilities, and the underlying mechanisms.  However there is enough evidence now that prenatal stress increases the risk for an adverse child outcome to make some recommendations. Programs targeting the reduction of anxiety, depression and stress in expectant mothers should be a cost-efficient method to improve problems such as low birth weight, prematurity and particularly neurodevelopmental problems. These programs might include policies regarding maternal employment and parental leave, but should not equally direct the activities and actions of all pregnant women because stress is a subjective experience that is not rigidly dictated by environmental events.  All new intervention programs should be evaluated as to child outcome.

One of the first steps toward the elaboration of appropriate intervention and prevention programs is to identify groups of women who are particularly at risk for experiencing different forms of stressors at different periods during their pregnancy, and assess how these different groups differ in terms of child outcomes.Because parents themselves should have the opportunity to improve their understanding of their child’s development, they should be informed by service providers of the mechanisms by which maternal stress can affect the intrauterine environment and subsequent development. Health care providers and psychosocial workers should be trained to communicate this information to parents because it can also help reduce mothers’ worries about their own levels of stress. At the individual level, every expecting mother should have access to professional help tailored to her needs and circumstances.

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