BibTex RIS Cite

Neurodevelopmental Outcomes of Prenatal Stress

Year 2012, Volume: 4 Issue: 1, 99 - 111, 01.03.2012
https://doi.org/10.5455/cap.20120407

Abstract

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 years; 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.

References

  • Sausenthaler S, Rzehak P, Chen CM, Arck P, Bockelbrink A, Schäfer T et al. Stress- Related maternal factors during pregnancy in relation to childhood eczema: results from the LISA study. J Investig Allergol Clin Immunol 2009; 19:481-487.
  • Hobel CJ, Goldstein A, Barrett ES. Psychosocial stress and pregnancy outcome. Clin Obstet Gynecol 2008; 51:333-348.
  • Davis EP, Glynn LM, Schetter CD, Hobel C, Chicz-Demet A, Sandman CA. Prenatal exposure to maternal depression and cortisol influences infant temperament. J Am Acad Child Psychiatry 2007; 46:737-746.
  • Karabekiroğlu K. Antenatal dönemde steroidlerin fötal beyin üzerine etkileri ve psikiyatrik sonuçlar. Yeni Symposium 2007; 45:99-106.
  • King BR, Nicholson RC, Smith R. Placental corticotrophin-releasing hormone, local effects and fetomaternal endocrinology. Stress 2001; 4:219-233.
  • Petraglia F, Florio P, Nappi C, Genazzani AR. Peptide signaling in human placenta and membranes: autocrine, paracrine, and endocrine mechanisms. Endocr Rev 1996; 17:156-186.
  • O'Donnell K, O'Connor TG, Glover V. Prenatal stress and neurodevelopment of the child: focus on the HPA axis and role of the placenta. Dev Neurosci 2009; 31:285- 292.
  • Holmes MC, Abrahamsen CT, French KL, Paterson JM, Mullins JJ, Seckl JR. The mother or the fetus? 11Beta-hydroxysteroid dehydrogenase type 2 null mice provide evidence for direct fetal programming of behavior by endogenous glucocorticoids . J Neurosci 2006; 26:3840-3844.
  • Dickerson PA, Lally BE, Gunnel E, Birkle DL, Salm AK. Early emergence of increased fearful behavior in prenatally stressed rats. Physiol Behav 2005; 86:586-593.
  • Van den Hove DLA, Blanco CE, Aendekerk B, Desbonnet L, Bruschettini M, Stein- busch HP, et al. Prenatal restraint stress and long-term affective consequences. Dev Neurosci 2005; 27:313-320.
  • Weinstock M. Alterations induced by gestational stress in brain morphology and behaviour of the offspring. Prog Neurobiol 2001; 65:427-451.
  • Kılıçoğlu A. Stres ve beyindeki etkileri: Bir gözden geçirme. Yeni Symposium 2007; 45:134-140.
  • Ramirez F, Fowell DJ, Puklavec M, Simmonds S, Mason D. Glucocorticoids promote a TH2 cytokine response by CD4+ T cells in vitro. J Immunol 1996; 156:2406-2412.
  • Blotta MH, DeKruyff RH, Umetsu DT. Corticosteroids inhibit IL- 12 production in human monocytes and enhance their capacity to induce IL-4 synthesis in CD4+ lymphocytes. J Immunol 1997; 158:5589-5595.
  • Rondó PHC. Maternal stress / distress and low birth weight, preterm birth and intra- uterine growth restriction: a review. Curr Womems Health Rev 2007; 3:13-29.
  • Johnson RC, Slade P. Obstetric complications and anxiety during pregnancy: is there a relationship? J Psychosom Obstet Gynecol 2003; 24:1-14.
  • Littleton HL, Breitkopf CR, Berenson AB. Correlates of anxiety symptoms during pregnancy and association with perinatal outcomes: A meta-analysis. Am J Obstet Gynecol 2007; 196:424-432.
  • Bergman K, Sarkar P, Glover V, O'Connor TG. Maternal prenatal cortisol and infant cognitive development: moderation by infant-mother attachment. Biol Psychiatry 2010; 67:1026-1032.
  • Rutter M, Silberg J. Gene-environment interplay in relation to emotional and behavioral disturbance. Annu Rev Psychol 2002; 53:463-490.
  • Rutter M, O'Connor TG. Are there biological programming effects for psychological development? Findings from a study of Romanian adoptees. Dev Psychol 2004; 40:81-94.
  • Bergman K, Sarkar P, O'Connor TG, Modi N, Glover V. Maternal stress during pregnancy predicts cognitive ability and fearfulness in infancy. J Am Acad Child Psychiatry 2007; 46:1454-1463.
  • Chapillon P, Patin V, Roy V, Vincent A, Caston J. Effects of pre- and postnatal stimulation on developmental, emotional, and cognitive aspects in rodents: a review. Dev Psychobiol 2002; 41:373-387.
  • Koo JW, Park CH, Choi SH, Kim NJ, Kim HS, Choe JC et al. The postnatal environment can counteract prenatal effects on cognitive ability, cell proliferation, and synaptic protein expression. FASEB J 2003; 17:1556-1568.
  • Mednick SA, Machon RA, Huttunen MO, Bonett D. Adult schizophrenia following prenatal exposure to an influenza epidemic. Arch Gen Psychiatry 1988; 45:189-192.
  • Weems CF, Stickle TR. Anxiety disorders in childhood: casting a nomological net. Clin Child Fam Psychol Rev 2005; 8:107-134.
  • Glynn LM, Wadhwa PD, Dunkel Schetter C, Chicz-Demet A, Sandman CA. When stress happens matters: Effects of earthquake timing on stress responsivity in pregnancy. Am J Obstet Gynecol 2001; 184:637-642.
  • Huizink AC, Mulder EJ, Buitelaar JK. Prenatal stress and risk for psychopathology: specific effects or induction of general susceptibility? Psychol Bull 2004; 130:115- 142.
  • Huttenen MO, Niskanen P. Prenatal loss of father and psychiatric disorders. Arch Gen Psychiatry 1978; 35:429-431.
  • Schneider ML. Delayed object permanence development in prenatally stressed rhesus monkey infants (Macaca mulatta). Occupational Therapy Journal of Research 1992; 12:96-110.
  • Watson, JB, Mednick SA, Huttunen M, Wang X. Prenatal teratogens and the development of adult mental illness. Dev Psychopathol 1999; 11:457-466.
  • King S, Laplante DP. The effects of prenatal maternal stress on children’s cognitive development: Project Ice Storm. Stress 2005; 8:35-45.
  • Laplante DP, Brunet A, Schmitz N, Ciampi A, King S. Project Ice Storm: prenatal maternal stress affects cognitive and linguistic functioning in 5 1/2-year-old children. J Am Acad Child Psyhiatry 2008; 47:1063-1072.
  • Van den Bergh BR, Marcoen A. High antenatal maternal anxiety is related to ADHD symptoms, externalizing problems, and anxiety in 8- and 9-year-olds. Child Dev 2004; 75:1085-1097.
  • O'Connor TG, Heron J, Golding J, Beveridge M, Glover V. Maternal antenatal anxiety and children's behavioural/ emotional problems at 4 years. Br J Psychiatry 2002; 180:502-508.
  • O'Connor TG, Heron J, Golding J, Glover V, Team AS. Maternal antenatal anxiety and behavioural/emotional problems in children: a test of a programming hypothesis. J Child Psychol Psychiatry 2003; 44:1025-1036.
  • Gitau R, Fisk NM, Teixeira JMA, Cameron A, Glover V. Fetal hypothalamic- pituitary-adrenal stress responses to invasive procedures are independent of maternal responses. J Clin Endocrinol Metab 2001; 86:104-109.
  • O'Connor TG, Ben-Shlomo Y, Heron J, Golding J, Adams D, Glover V. Prenatal anxiety predicts individual differences in cortisol in pre-adolescent children. Biol Psychiatry 2005; 58:211-217.
  • Ruttle PL, Shirtcliff EA, Serbin LA, Fisher DB, Stack DM, Schwartzman AE. Disentangling psychobiological mechanisms underlying internalizing and externalizing behaviors in youth: longitudinal and concurrent associations with cortisol. Horm Behav 2011; 59:123-132.
  • Putman P, Roelofs K. Effects of single cortisol administrations on human affect reviewed: Coping with stress through adaptive regulation of automatic cognitive processing. Psychoneuroendocrinology 2011; 36:439-448.
  • Van den Bergh BR, Mennes M, Oosterlaan J, Stevens V, Stiers P, Marcoen A, Lagae L. High antenatal maternal anxiety is related to impulsivity during performance on cognitive tasks in 14- and 15-year-olds. Neurosci Biobehav Rev 2005; 29:259-269.
  • Van den Bergh BR, Van Calster B, Smits T, Van Huffel S, Lagae L. Antenatal maternal anxiety is related to HPA-axis dysregulation and self-reported depressive symptoms in adolescence: a prospective study on the fetal origins of depressed mood. Neuropsychopharmacology 2008; 33:536-545.
  • Li J, Olsen J, Vestergaard M, Obel C. Attention-deficit/hyperactivity disorder in the offspring following prenatal maternal bereavement: a nationwide follow-up study in Denmark. Eur Child Adolesc Psychiatry 2010; 19:747-753.
  • Grizenko N, Shayan YR, Polotskaia A, Ter-Stepanian M, Joober R. Relation of maternal stress during pregnancy to symptom severity and response to treatment in children with ADHD. J Psychiatry Neurosci 2008; 33:10-16.
  • Linnet KM, Dalsgaard S, Obel C, Wisborg K, Henriksen TB, Rodriguez A, Kotimaa A, Moilanen I, Thomsen PH, Olsen J, Jarvelin MR. Maternal lifestyle factors in pregnancy risk of attention deficit hyperactivity disorder and associated behaviors: review of the current evidence. Am J Psychiatry 2003; 160:1028-1040.
  • Rodriguez A, Bohlin G. Are maternal smoking and stress during pregnancy related to ADHD symptoms in children? J Child Psychol Psychiatry 2005; 46: 246-254.
  • Özbek A, Akhisaroğlu M, Dursun OB, Taş FV, Yılmaz O, Şemin İ. Effects of early litter loss on maternal behavior and subsequent generations in rats: an attempt for an animal model for loss of a baby. Nöropsikiyatri Arşivi 2011; 48:44-52.
  • Weinstock M. Intrauterine factors as determinants of depressive disorder. Isr J Psychiatry Relat Sci 2010; 47:36-45.
  • Tuccori M, Montagnani S, Testi A, Ruggiero E, Mantarro S, Scollo C et al. Use of selective serotonin reuptake inhibitors during pregnancy and risk of major and cardiovascular malformations: an update. Postgrad Med 2010; 122:49-65.
  • Alwan S, Friedman JM. Safety of selective serotonin reuptake inhibitors in pregnancy. CNS Drugs 2009; 23:493-509.
  • Bakker MK, De Walle HE, Wilffert B, de Jong-Van den Berg LT. Fluoxetine and infantile hypertrophic pylorus stenosis: a signal from a birth defects-drug exposure surveillance study. Pharmacoepidemiol Drug Saf 2010; 19:808-813.
  • Malm H, Artama M, Gissler M, Ritvanen A. Selective serotonin reuptake inhibitors and risk for major congenital anomalies. Obstet Gynecol 2011; 118:111-120.
  • Çalık KY, Aktaş S. Gebelikte depresyon: sıklık, risk faktörleri ve tedavisi. Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry 2011; 3:142-162.
  • M. Genco Usta, Uzm.Dr., Beytepe Asker Hastanesi Çocuk Psikiyatrisi Bölümü, Ankara; Adem Balıkçı,
  • Uzm.Dr., Samsun Asker Hastanesi, Samsun

Prenatal Stresin Nörogelişimsel Etkileri

Year 2012, Volume: 4 Issue: 1, 99 - 111, 01.03.2012
https://doi.org/10.5455/cap.20120407

Abstract

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.

References

  • Sausenthaler S, Rzehak P, Chen CM, Arck P, Bockelbrink A, Schäfer T et al. Stress- Related maternal factors during pregnancy in relation to childhood eczema: results from the LISA study. J Investig Allergol Clin Immunol 2009; 19:481-487.
  • Hobel CJ, Goldstein A, Barrett ES. Psychosocial stress and pregnancy outcome. Clin Obstet Gynecol 2008; 51:333-348.
  • Davis EP, Glynn LM, Schetter CD, Hobel C, Chicz-Demet A, Sandman CA. Prenatal exposure to maternal depression and cortisol influences infant temperament. J Am Acad Child Psychiatry 2007; 46:737-746.
  • Karabekiroğlu K. Antenatal dönemde steroidlerin fötal beyin üzerine etkileri ve psikiyatrik sonuçlar. Yeni Symposium 2007; 45:99-106.
  • King BR, Nicholson RC, Smith R. Placental corticotrophin-releasing hormone, local effects and fetomaternal endocrinology. Stress 2001; 4:219-233.
  • Petraglia F, Florio P, Nappi C, Genazzani AR. Peptide signaling in human placenta and membranes: autocrine, paracrine, and endocrine mechanisms. Endocr Rev 1996; 17:156-186.
  • O'Donnell K, O'Connor TG, Glover V. Prenatal stress and neurodevelopment of the child: focus on the HPA axis and role of the placenta. Dev Neurosci 2009; 31:285- 292.
  • Holmes MC, Abrahamsen CT, French KL, Paterson JM, Mullins JJ, Seckl JR. The mother or the fetus? 11Beta-hydroxysteroid dehydrogenase type 2 null mice provide evidence for direct fetal programming of behavior by endogenous glucocorticoids . J Neurosci 2006; 26:3840-3844.
  • Dickerson PA, Lally BE, Gunnel E, Birkle DL, Salm AK. Early emergence of increased fearful behavior in prenatally stressed rats. Physiol Behav 2005; 86:586-593.
  • Van den Hove DLA, Blanco CE, Aendekerk B, Desbonnet L, Bruschettini M, Stein- busch HP, et al. Prenatal restraint stress and long-term affective consequences. Dev Neurosci 2005; 27:313-320.
  • Weinstock M. Alterations induced by gestational stress in brain morphology and behaviour of the offspring. Prog Neurobiol 2001; 65:427-451.
  • Kılıçoğlu A. Stres ve beyindeki etkileri: Bir gözden geçirme. Yeni Symposium 2007; 45:134-140.
  • Ramirez F, Fowell DJ, Puklavec M, Simmonds S, Mason D. Glucocorticoids promote a TH2 cytokine response by CD4+ T cells in vitro. J Immunol 1996; 156:2406-2412.
  • Blotta MH, DeKruyff RH, Umetsu DT. Corticosteroids inhibit IL- 12 production in human monocytes and enhance their capacity to induce IL-4 synthesis in CD4+ lymphocytes. J Immunol 1997; 158:5589-5595.
  • Rondó PHC. Maternal stress / distress and low birth weight, preterm birth and intra- uterine growth restriction: a review. Curr Womems Health Rev 2007; 3:13-29.
  • Johnson RC, Slade P. Obstetric complications and anxiety during pregnancy: is there a relationship? J Psychosom Obstet Gynecol 2003; 24:1-14.
  • Littleton HL, Breitkopf CR, Berenson AB. Correlates of anxiety symptoms during pregnancy and association with perinatal outcomes: A meta-analysis. Am J Obstet Gynecol 2007; 196:424-432.
  • Bergman K, Sarkar P, Glover V, O'Connor TG. Maternal prenatal cortisol and infant cognitive development: moderation by infant-mother attachment. Biol Psychiatry 2010; 67:1026-1032.
  • Rutter M, Silberg J. Gene-environment interplay in relation to emotional and behavioral disturbance. Annu Rev Psychol 2002; 53:463-490.
  • Rutter M, O'Connor TG. Are there biological programming effects for psychological development? Findings from a study of Romanian adoptees. Dev Psychol 2004; 40:81-94.
  • Bergman K, Sarkar P, O'Connor TG, Modi N, Glover V. Maternal stress during pregnancy predicts cognitive ability and fearfulness in infancy. J Am Acad Child Psychiatry 2007; 46:1454-1463.
  • Chapillon P, Patin V, Roy V, Vincent A, Caston J. Effects of pre- and postnatal stimulation on developmental, emotional, and cognitive aspects in rodents: a review. Dev Psychobiol 2002; 41:373-387.
  • Koo JW, Park CH, Choi SH, Kim NJ, Kim HS, Choe JC et al. The postnatal environment can counteract prenatal effects on cognitive ability, cell proliferation, and synaptic protein expression. FASEB J 2003; 17:1556-1568.
  • Mednick SA, Machon RA, Huttunen MO, Bonett D. Adult schizophrenia following prenatal exposure to an influenza epidemic. Arch Gen Psychiatry 1988; 45:189-192.
  • Weems CF, Stickle TR. Anxiety disorders in childhood: casting a nomological net. Clin Child Fam Psychol Rev 2005; 8:107-134.
  • Glynn LM, Wadhwa PD, Dunkel Schetter C, Chicz-Demet A, Sandman CA. When stress happens matters: Effects of earthquake timing on stress responsivity in pregnancy. Am J Obstet Gynecol 2001; 184:637-642.
  • Huizink AC, Mulder EJ, Buitelaar JK. Prenatal stress and risk for psychopathology: specific effects or induction of general susceptibility? Psychol Bull 2004; 130:115- 142.
  • Huttenen MO, Niskanen P. Prenatal loss of father and psychiatric disorders. Arch Gen Psychiatry 1978; 35:429-431.
  • Schneider ML. Delayed object permanence development in prenatally stressed rhesus monkey infants (Macaca mulatta). Occupational Therapy Journal of Research 1992; 12:96-110.
  • Watson, JB, Mednick SA, Huttunen M, Wang X. Prenatal teratogens and the development of adult mental illness. Dev Psychopathol 1999; 11:457-466.
  • King S, Laplante DP. The effects of prenatal maternal stress on children’s cognitive development: Project Ice Storm. Stress 2005; 8:35-45.
  • Laplante DP, Brunet A, Schmitz N, Ciampi A, King S. Project Ice Storm: prenatal maternal stress affects cognitive and linguistic functioning in 5 1/2-year-old children. J Am Acad Child Psyhiatry 2008; 47:1063-1072.
  • Van den Bergh BR, Marcoen A. High antenatal maternal anxiety is related to ADHD symptoms, externalizing problems, and anxiety in 8- and 9-year-olds. Child Dev 2004; 75:1085-1097.
  • O'Connor TG, Heron J, Golding J, Beveridge M, Glover V. Maternal antenatal anxiety and children's behavioural/ emotional problems at 4 years. Br J Psychiatry 2002; 180:502-508.
  • O'Connor TG, Heron J, Golding J, Glover V, Team AS. Maternal antenatal anxiety and behavioural/emotional problems in children: a test of a programming hypothesis. J Child Psychol Psychiatry 2003; 44:1025-1036.
  • Gitau R, Fisk NM, Teixeira JMA, Cameron A, Glover V. Fetal hypothalamic- pituitary-adrenal stress responses to invasive procedures are independent of maternal responses. J Clin Endocrinol Metab 2001; 86:104-109.
  • O'Connor TG, Ben-Shlomo Y, Heron J, Golding J, Adams D, Glover V. Prenatal anxiety predicts individual differences in cortisol in pre-adolescent children. Biol Psychiatry 2005; 58:211-217.
  • Ruttle PL, Shirtcliff EA, Serbin LA, Fisher DB, Stack DM, Schwartzman AE. Disentangling psychobiological mechanisms underlying internalizing and externalizing behaviors in youth: longitudinal and concurrent associations with cortisol. Horm Behav 2011; 59:123-132.
  • Putman P, Roelofs K. Effects of single cortisol administrations on human affect reviewed: Coping with stress through adaptive regulation of automatic cognitive processing. Psychoneuroendocrinology 2011; 36:439-448.
  • Van den Bergh BR, Mennes M, Oosterlaan J, Stevens V, Stiers P, Marcoen A, Lagae L. High antenatal maternal anxiety is related to impulsivity during performance on cognitive tasks in 14- and 15-year-olds. Neurosci Biobehav Rev 2005; 29:259-269.
  • Van den Bergh BR, Van Calster B, Smits T, Van Huffel S, Lagae L. Antenatal maternal anxiety is related to HPA-axis dysregulation and self-reported depressive symptoms in adolescence: a prospective study on the fetal origins of depressed mood. Neuropsychopharmacology 2008; 33:536-545.
  • Li J, Olsen J, Vestergaard M, Obel C. Attention-deficit/hyperactivity disorder in the offspring following prenatal maternal bereavement: a nationwide follow-up study in Denmark. Eur Child Adolesc Psychiatry 2010; 19:747-753.
  • Grizenko N, Shayan YR, Polotskaia A, Ter-Stepanian M, Joober R. Relation of maternal stress during pregnancy to symptom severity and response to treatment in children with ADHD. J Psychiatry Neurosci 2008; 33:10-16.
  • Linnet KM, Dalsgaard S, Obel C, Wisborg K, Henriksen TB, Rodriguez A, Kotimaa A, Moilanen I, Thomsen PH, Olsen J, Jarvelin MR. Maternal lifestyle factors in pregnancy risk of attention deficit hyperactivity disorder and associated behaviors: review of the current evidence. Am J Psychiatry 2003; 160:1028-1040.
  • Rodriguez A, Bohlin G. Are maternal smoking and stress during pregnancy related to ADHD symptoms in children? J Child Psychol Psychiatry 2005; 46: 246-254.
  • Özbek A, Akhisaroğlu M, Dursun OB, Taş FV, Yılmaz O, Şemin İ. Effects of early litter loss on maternal behavior and subsequent generations in rats: an attempt for an animal model for loss of a baby. Nöropsikiyatri Arşivi 2011; 48:44-52.
  • Weinstock M. Intrauterine factors as determinants of depressive disorder. Isr J Psychiatry Relat Sci 2010; 47:36-45.
  • Tuccori M, Montagnani S, Testi A, Ruggiero E, Mantarro S, Scollo C et al. Use of selective serotonin reuptake inhibitors during pregnancy and risk of major and cardiovascular malformations: an update. Postgrad Med 2010; 122:49-65.
  • Alwan S, Friedman JM. Safety of selective serotonin reuptake inhibitors in pregnancy. CNS Drugs 2009; 23:493-509.
  • Bakker MK, De Walle HE, Wilffert B, de Jong-Van den Berg LT. Fluoxetine and infantile hypertrophic pylorus stenosis: a signal from a birth defects-drug exposure surveillance study. Pharmacoepidemiol Drug Saf 2010; 19:808-813.
  • Malm H, Artama M, Gissler M, Ritvanen A. Selective serotonin reuptake inhibitors and risk for major congenital anomalies. Obstet Gynecol 2011; 118:111-120.
  • Çalık KY, Aktaş S. Gebelikte depresyon: sıklık, risk faktörleri ve tedavisi. Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry 2011; 3:142-162.
  • M. Genco Usta, Uzm.Dr., Beytepe Asker Hastanesi Çocuk Psikiyatrisi Bölümü, Ankara; Adem Balıkçı,
  • Uzm.Dr., Samsun Asker Hastanesi, Samsun
There are 54 citations in total.

Details

Primary Language Turkish
Journal Section Review
Authors

M. Genco Usta This is me

Adem Balıkçı This is me

Publication Date March 1, 2012
Published in Issue Year 2012 Volume: 4 Issue: 1

Cite

AMA Usta MG, Balıkçı A. Prenatal Stresin Nörogelişimsel Etkileri. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. March 2012;4(1):99-111. doi:10.5455/cap.20120407

Creative Commons License
Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.