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Cardiovascular effects of prenatal stress-Are there implications for cerebrovascular, cognitive and mental health

Julia J Müller1, Iwa Antonow-Schlorke1, Nasim Kroegel1

  • 1Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany.

Neuroscience and Biobehavioral Reviews
|November 12, 2019
PubMed

Insights

Prenatal stress, especially maternal anxiety, can negatively impact fetal circulation and neurodevelopment, potentially leading to cardiovascular issues. More research is needed on long-term effects on brain health and cognition.

Area of Science:

  • Neuroscience
  • Cardiovascular Science
  • Developmental Biology

Background:

  • Prenatal stress is known to affect offspring cognitive and mental health.
  • The impact of prenatal stress on cardiovascular dysfunction and its link to cerebrovascular, cognitive, and mental health disorders requires further investigation.
  • Maternal stress and prenatal glucocorticoid (GC) exposure have distinct programming effects due to placental differences in cortisol inactivation and GC permeability.

Purpose of the Study:

  • To review the programming effects of prenatal stress and glucocorticoid exposure on cardiovascular dysfunction.
  • To explore the potential modulation of cerebrovascular, cognitive, and mental health disorders by prenatal stress-induced cardiovascular changes.
  • To differentiate the programming effects of maternal stress versus direct GC exposure during gestation.

Main Methods:

  • Review of experimental data on maternal stress and prenatal GC exposure in early and mid-gestation.
  • Analysis of potential programming mechanisms including cardiac and kidney development, the renin-angiotensin-aldosterone system, stress axis, and vasculature.
  • Identification of gaps in human studies, particularly concerning older age and cerebrovascular/cognitive/mental health outcomes.

Main Results:

  • Maternal stress, particularly anxiety, adversely affects maternal-fetal circulation via sympathetic nervous system activation and increased fetal catecholamines, potentially impairing neurodevelopment.
  • Unlike maternal stress, GC exposure has different programming effects, with synthetic GCs crossing the placenta more readily.
  • Experimental data suggest severe maternal stress and GC exposure may increase cardiovascular disorder risk, with programming mechanisms involving developmental aberrations and functional vascular changes.

Conclusions:

  • Prenatal stress, especially maternal anxiety, can initiate cardiovascular programming with potential long-term health consequences.
  • While experimental data exist, human studies on the long-term cardiovascular, cerebrovascular, cognitive, and mental health consequences of prenatal stress are scarce, particularly in older populations.
  • Further research is crucial to fully understand the complex interplay between prenatal stress, cardiovascular health, and neurodevelopmental outcomes across the lifespan.

Keywords:
AnxietyAutonomic nervous systemBlood pressureCerebral blood flowDepressionHypothalamus-pituitary-adrenocortical axisMaternal-fetal circulationSympathetic activityUterine and umbilical blood flowVascular reactivity

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