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New research links prenatal stress as a pathway to personality disorder

New research published in The British Journal of Psychiatry has found that exposure to stress during pregnancy increases the odds of personality disorder in offspring, independent of other psychiatric disorders.

These findings based on a sample of 3626 subjects in Finland, provide evidence to support a long held belief or “old wives’ tale”, that a stressful pregnancy could lead to a fretful or “difficult” child.

They also highlight the importance of prenatal care and societal considerations to help ensure that expectant mothers can be free of unnecessary stress during pregnancy.

Stress has long been recognised as playing a role in the development of a number of ailments in the person concerned, but acceptance of research showing the effects on the fetus and later development have been slower to catch up. As early as the 1940’s Dr Lester Sontag published a paper following his wartime observations of the effects of stress on the expectant mother. He suggested that maternal stress heightened a child’s biological susceptibility to emotional stress and that this was a primary physical mechanism of which emotional hyper-sensitivity was a secondary outcome.

Thomas Verny described how maternal -fetal communication is endocrine (hormonal) during pregnancy rather than neural, while others have demonstrated that hormonal manipulation during gestation can alter the structure of the developing brain (Moir and Jessel 1991).

The stress response alters the hormonal status of the mother passing through the circulation to the developing child so that, “chemically, the baby feels what the mother is feeling” (Goddard Blythe 2017). This does not mean that the fetus will go on to develop a personality disorder, but that the impact of maternal stress may influence the setting of the fetal hormonal “clock” for later life, potentially heightening a child’s biological susceptibility to stress and the need to develop coping or avoidance mechanisms.

Michael Teicher described this in relation to fetal experience of maternal trauma when neurons alter their course in the normal migratory process to target addresses in the brain, thereby by-passing or blocking off the possibility of re-experience of pain in the future.

Later in life, when faced with stress-laden situations, which cannot be resolved through circumstances or fear of the outcome, some people will develop habitual patterns of avoidance or over-reactive behaviour, which become an endemic part of the personality (Blythe 1973).

In the western world we have come along way in making child birth safer; in reducing the rate of mortality in children under 5 and protecting against the most feared diseases of previous centuries. Alongside these improvements, societies driven by economics are not so understanding of the needs of the expectant mother and unborn child. Stress takes many forms from abuse and extreme poverty at one end of the scale to the demands of maintaining a job and relationships at the other.

What happens to women, before, during and after pregnancy matters.


Brannigan R et al. The role of prenatal stress as a pathway to personality disorder: longitudinal birth cohort study. The British Journal of Psychiatry. 6th September 2019.

Sontag LW, War and the foetal maternal relationship. Marriage and Family Living. 6. 1944. 1-5.

Verny T, The secret life of the unborn child. Sphere Books. London. 1982.

Moir A, Jessel D. Brain sex. The real difference between men and women. Mandarin. London. 1991.

Goddard Blythe SA, Raising Happy Healthy Children. Why Mothering Matters. Hawthorn Press. 2017.

Blythe P, Stress disease. The growing plague. Arthur Barker. London . 1973.

Teicher MH, Wounds that time won’t heal. The neurobiology of child abuse. Cerebrum 2/4. 2000

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