Maternal Stress and Programming of the Fetal Hypothalamic-Pituitary-Adrenal Axis

The hypothalamic-pituitary-adrenal axis (HPAA) is the key regulator of the stress response in mammals acting to restore homeostasis during these periods. Programming of the HPAA is influenced by events that occur in utero. For example, periods of maternal stress during gestation can lead to alterations in the programming of the fetal HPAA often leading to a hyper-active cortisol response to stress later in life. Animal models have proven useful for studying programming of the fetal HPAA and have provided insight into factors that influences it's programming such as the timing and type of stressor and gender differences. With increasing interest in this field of research, much has been learned about the possible mechanisms at play and treatment options available to restore functioning of the HPAA; this is the focus of this review.