Mothers in stress: consequences for the offspring.

No memories exist on one's time before birth. However, this does not imply that the developing fetus is not susceptible to external impulses. On the contrary, the fetus is extremely vulnerable e.g. to environmental challenges, and a wealth of data reveals that conditions in utero affect the health of the fetus before and after birth. Threats for the growing fetus include psychological challenges perceived by the mother, e.g. high levels of stress during pregnancy. However, stress experienced during pregnancy not only leads to pregnancy complications like miscarriage, pre-eclampsia, preterm parturition, low birth weight or major congenital malformations, stress also increases the risk of the child to develop diseases in the subsequent periods of life. This condition is termed fetal programming of adult disease. Programming agents seem to include growth factors, cytokines and hormones, all of which can be altered by stress. As a consequence, such 'stress-modified' systems of the offspring are more susceptible to environmental influences during later life, e.g. the development of atopic diseases upon exposure to antigens. The present review illuminates the complexity of stress perception on fetal programming focusing predominately on the onset of atopic diseases on the background of published evidence from immunology, endocrinology, neurobiology and neonatology.