About a different programming!

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Vivian Mary, daughter of Gertrude Mary Frances was born on November 5, 1913. The extraordinary beauty of the child was no surprise; On the recommendation of the family governess, Gertrude spent a significant part of her pregnancy watching the snow-capped peaks of Kangchenjunga Mountain, [1] one of the highest in the Himalayas. It may not have been out of place to follow local custom and belief, as Vivian was later celebrated as Vivien Leigh.

How a pregnant woman’s subjective experience can affect a child’s characteristics is an eternally interesting question, but individual cases such as the star of Gone with the Wind don’t guarantee great insights. Science requires and implies the accumulation of experience. We who grew up with Natalie Wood movies missed that train, but today it might be worth asking Adriana Lima’s mother if her pregnancy went in the wake of extraordinary expectations.
Many researchers today are serious about such issues, but with a focus on those processes during pregnancy that are both more frequent and easier to define and measure than is the case with enjoying the natural beauty of Darjeeling -experiences such as malnutrition or severe stress, as well as outcomes that can be clearly classified, often pathological conditions in the domain of physical or psychological functioning (from diabetes and cardiac problems to schizophrenia). Atypical problem (as would be the case if we were to follow the examples of exceptional cases (from Vivien Leigh to Adriana Lima) is that in such a retrospective study the insight is burdened by the so-called survival bias, overlooking which processes could influence why these particular cases led to this condition and others did not.

Prospective studies of prenatal stress in humans cannot, of course, be conducted, so these challenges must be overcome in other ways. Another problem is that the effects of the prenatal experience often occur with great delay (the so-called organizing effects; the pathology is "programmed" in one period of development to manifest itself in certain conditions in a later period). Therefore, it is difficult to exclude contamination with other influences that are included in the meantime. Two key hypotheses about pathology programming relate to fetal malnutrition and fetal overexposure to glucocorticoids (e.g., cortisol). The relative share of genetic and environmental factors is practically unknown and it is difficult to distinguish whether in some conditions it is a matter of genetics or the perpetuation of programming effects between generations.

A recent study also offered, for the first time, quantitative indicators that the effects of stress can be transmitted even when acquired before pregnancy; namely, in the childhood of the parents [2]. In a sample of 2,529 children, one-fifth of parents reported experiencing four or more severe stressful and potentially traumatic experiences in their childhood. Especially in the case of mothers, there turned out to be a positive correlation with a number of behavioral problems in their children, including signs of attention deficit hyperactivity disorder and emotional dysfunction.

Let's go back to the experience during pregnancy. The story of the so-called prenatal stress is also illustrative for recognizing the importance of the physiological nature of stress, which occurs here practically in isolation from the psychological aspect. In this sense, the unborn child cannot experience stress, so it is practically prepartum (prenatal) stress of the pregnant woman, and its physiological effects are transmitted through the placenta (part of the hormones that occur with an increase in stress can pass through the so-called placental barrier). on fetal physiology.

There are many studies on the intergenerational effects of maternal psychosocial stress during pregnancy. Regarding animal models, one of the classical studies of the effects of prenatal stress exposure [3] postulated that male rats exposed prenatally to stress showed a lower level of copulatory behavior and an increased rate of reactions typical of females (lordosis), due to stress-mediated changes in the ratio. adrenal and gonadal androgens during critical stages of sexual differentiation. Physiological mechanisms of androgen regulation in the fetus, in relation to maternal stress, include interactions with glucocorticoids. Although there is considerable evidence that the regulatory mechanisms of fetal concentration of these different hormones do not include identical elements, there are findings that maternal testosterone and fetal cortisol are independently correlated with fetal plasma testosterone in both sexes. [4] Glucocorticoids are known to inhibit androgen production in vitro [5], and such an inverse relationship is considered normal also in adults, for whom there is evidence that stress reduces testosterone levels.

The so-called transgenerational PTSD (post-traumatic stress disorder) is still a rather controversial topic in modern psychopathology and is mainly studied within the framework of the approach to family therapy. For now, the preferred etiological model seems to emphasize social factors (parenting styles, etc.). Apparently there are no clear behavioral signs of trauma in the second generation. The nonspecific nature of the symptoms encourages the use of a general assessment of behavior in epidemiological studies, at least in terms of an early indication of potentially more serious disorders.
It is known that e.g. there are transgenerational effects of PTSD in terms of regulation of circadian cortisol secretion. [6] There are findings that suggest that the effects of maternal PTSD in cortisol secretion can be observed very early in the life of the offspring. This emphasizes the importance of in utero effects as contributors to a putative biological risk factor for the development of post-traumatic stress disorder. [7] However, the mechanisms of this effect are still unclear.

However, another issue needs to be considered. The effects of stress in terms of the regulation of cortisol secretion differ according to the duration of stress, and especially in fully developed post-traumatic stress disorder. These differences reflect not only the type (duration) of stress, but also a certain vulnerability or resistance to PTSD. However, there are somewhat conflicting views (and evidence) on this issue, and the key issue appears to be related to cortisol concentrations during exposure to a traumatic event, rather than later [8].Previous research on the effects of prenatal stress on people has been conducted mainly after crisis situations such as the so-called. the Dutch famine (during the winter of 1944/1945), the Canadian ice storm and similar situations. Most of these studies are epidemiological in nature. We in BiH have yet to consolidate our knowledge of what the war has brought to those who have not even been born [9].


Finally, something comforting should be added for those who thought that pronounced prenatal stress necessarily leads to pathological outcomes. Just as not all children whose mothers gave birth in the foothills of the magical Himalayas are endowed with the beauty of Vivien Leigh, so not every unpleasant impact will be reflected in the health of the child. It should be reminded that science in principle serves to give us lessons for the future by analyzing data from the past. The miraculous physiology of the human body, in conjunction with psychology, says that the whole of a very complex pregnancy experience [10] is also subject to modifications in the desired direction - and when there are strong stressors during pregnancy, the pregnant woman's lifestyle, especially sleep, diet and exercise [11], have a mediating role in determining the extent to which adverse effects will ultimately manifest. Science tells us that we need to make more efforts to protect those who are yet to come among us.

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