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Yıl:2012; Cilt: 4; Sayı: 1>> Özet
TAM METİN
Psikiyatride Güncel Yaklaşımlar; 2012;4(1):99-111
Prenatal Stresin Nörogelişimsel Etkileri
MG Usta, A Balıkçı
Beytepe Asker Hastanesi, Ankara
Prenatal stresin psikopatoloji üzerine etkisi birçok hayvan ve insan çalışmasın-da gösterilmiştir. Prenatal dönemde stresin hipotalamo-pituiter-adrenokortikal yolun negatif geribildirim regülasyonunda bozulmaya ve aşırı aktiviteye neden olduğu saptanmıştır. Buna ek olarak prenatal stresin doğum komplikasyonu riskini arttırdığı, perinatal dönemde yenilik karşısında uyum sağlamada güçlük, ürkek davranışların gözlenmesine, 3-5 yaş döneminde toplam zeka bölümünde ve dikkat performansında düşüklük, dil becerilerinde geriliğe yol açtığı, ergenlik döneminde ise dikkat eksikliği hiperaktivite bozukluğu ile ilişkili belirtilere neden olduğu, dürtüsellik, kaygı ve depresif bozukluk riskini artırdığı gösterilmiştir. Stresin gebeliğin 12-22. haftalarda yaşanması durumunda etkilenmenin daha fazla olacağı düşünülmektedir. Prenatal stresin değerlendirildiği takip programlarının oluşturulması ve doğal afet, terör saldırısı gibi yaşam olaylarına maruz kalan gebelerin hızlı bir şekilde güvenli ve temel ihtiyaçlarının sağlandığı alanlara sevk edilmesi toplum sağlığı açısından önemli olabilir.
Neurodevelopmental Outcomes of Prenatal Stress
The influence of prenatal stress on psychopathology has been observed in many animal and human studies. In many studies, stress during prenatal period has been shown to result in negative feedback dysregulation and hyperactivity of hypothalamo-pituitary-adrenocortical axis. Prenatal stres also may cause increased risk of birth complications, startle or distress in response to novel and surprising stimuli during infancy; lower Full Scale IQs, [language] abilities and attention deficiency in period of 3-5 [year]s; increased risk of attention deficit hyperactivity syndrome, anxiety symptoms, depressive disorder and impulsivity during adolescence. Additionally, timing of prenatal stress is also important and 12-22 weeks of gestation seems to be the most vulnerable period. The results underline the need for early prevention and intervention programs for highly anxious women during pregnancy. Administration of prenatal stress monitoring to public health programs or removing pregnant women who have been exposed to life events such as natural disaster, terror attack to secure areas that provide basic needs may be crucial.

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