By Marc Dellière, Medical Consultant & Trainer – Specialist in Stress, Prevention & Integrative Health
She sometimes cries for no reason. She worries about giving birth, her body, her baby. Yet all the tests are reassuring.
Prenatal stress is a common but underestimated experience. It is not just a temporary discomfort: it is a biological, emotional, and relational modulator with measurable effects on the health of the mother and her unborn child.
A lasting biological imprint
During pregnancy, maternal stress activates the HPA axis, increases cortisol, and alters fetal brain development: amygdala, hippocampus, prefrontal cortex.
Prenatal stress affects myelination, synaptic density, and the maturation of emotional circuits, with a behavioral impact observable from early childhood.
These brain changes are associated with increased vulnerability to anxiety, ADHD, and mood disorders.
Prenatal stress also alters the balance between inhibitory (GABA) and excitatory (glutamate) neurotransmitters and activates persistent neuroinflammatory processes. This dual disruption is a major factor in the emergence of early anxious behaviors.
The fetal brain picks up on the emotional state of its mother. It is not stress itself, but its lack of regulation, that is harmful.
Is stress transmissible?
Maternal anxiety alters the expression of genes linked to stress regulation (NR3C1, FKBP5), influencing the child's emotional sensitivity and ability to adapt to the world.
Transgenerational effects have been observed in children of mothers exposed to stress, regardless of genetic factors.
A simple tool for detection: the PRAQ-R2
The Pregnancy-Related Anxiety Questionnaire – Revised 2 is a validated, short, and sensitive tool that can be used from the second trimester onwards. It identifies anxiety specific to pregnancy, as distinct from generalized anxiety.
Antonelli et al.: “Early detection with tools such as the PRAQ-R2 allows action to be taken before the behavioral cascade sets in.”
It explores three key dimensions:
- Fear of childbirth → “I'm afraid of losing control.”
- Concerns about the baby's health → “I'm afraid my baby will be sick.”
- Body concerns → “I'm worried I won't get my body back.”
- The PRAQ-R2 is correlated with postpartum well-being and the quality of the mother-child bond, and allows for targeted guidance.
Course of action
Prenatal mindfulness (Mindfulness-Based Childbirth and Parenting )
Perinatal CBT, hypnosis, relaxation
Natural supplements:
- Omega-3, magnesium, vitamin D
- Lactium®, a bioactive peptide that acts on GABA-A α2 receptors, which are involved in mild to moderate anxiety. Its GABAergic action is particularly relevant for rebalancing the GABA/glutamate balance, which is often disrupted in the context of prenatal stress. Lactium® has an excellent tolerance profile, including during the perinatal period, with no sedative effect or addiction. It is a first-line option for pregnant women with moderate stress, especially in early pregnancy
- Well-tolerated plants under supervision: lemon balm, passionflower (no documented uterotonic effect).
In summary
Identifying pregnancy-related anxiety is not overkill. It is better prevention for both mother and child.
✅ Prenatal stress causes lasting changes in brain development.
✅ The PRAQ-R2 is a short, reliable, clinically useful tool.
✅ Early intervention has an impact on two generations.
PRAQ-R2 - The 10 questions
Each item is rated on a scale of 1 (not at all) to 5 (extremely). 3 subscales:
🔹 Fear of childbirth (3 items)
I am afraid of being in pain during childbirth.
I am afraid of complications during childbirth.
I am worried about having to give birth.
🔹 Concerns about the child's health (4 items)
I am worried that my baby will have abnormalities or health problems.
I am afraid that something is wrong with the baby.
I am concerned about the baby's health.
I am anxious about the idea of my baby being born sick.
🔹 Physical concerns (3 items)
I am embarrassed by the changes in my body.
I am worried that I will not regain my figure after pregnancy.
I feel uncomfortable with my body at the moment.
✅ Clinical interpretation (indicative)
There is no official threshold, but a score of ≥ 3 on several items indicates significant anxiety.
A high average per subscale may warrant specific support.
The PRAQ-R2 can be repeated remotely to monitor progress.
Learn more about Lactium for stress management!
Scientific sources :
Roshan-Milani, S., Seyyedabadi, B., Saboory, E., Parsamanesh, N., & Mehranfard, N. (2021). Prenatal stress and increased susceptibility to anxiety-like behaviors: role of neuroinflammation and balance between GABAergic and glutamatergic transmission. Stress, 24(5), 481–495. https://doi.org/10.1080/10253890.2021.1942828
Van den Bergh BRH, van den Heuvel MI, Lahti M, Braeken M, de Rooij SR, Entringer S, Hoyer D, Roseboom T, Räikkönen K, King S, Schwab M. Prenatal developmental origins of behavior and mental health: The influence of maternal stress in pregnancy. Neurosci Biobehav Rev. 2020 Oct;117:26-64. doi: 10.1016/j.neubiorev.2017.07.003. Epub 2017 Jul 28. PMID: 28757456.
Antonelli MC, Frasch MG, Rumi M, Sharma R, Zimmermann P, Molinet MS, Lobmaier SM. Early Biomarkers and Intervention Programs for the Infant Exposed to Prenatal Stress. Curr Neuropharmacol. 2022;20(1):94-106. doi: 10.2174/1570159X19666210125150955. PMID: 33550974; PMCID: PMC9199558.
Huizink AC, Delforterie MJ, Scheinin NM, Tolvanen M, Karlsson L, Karlsson H. Adaption of pregnancy anxiety questionnaire-revised for all pregnant women regardless of parity: PRAQ-R2. Arch Womens Ment Health. 2016 Feb;19(1):125-32. doi: 10.1007/s00737-015-0531-2. Epub 2015 May 14. PMID: 25971851; PMCID: PMC4728175.
Marie Simonot. Le stress prénatal : conséquences sur la descendance et prévention des risques chez la femme enceinte. Sciences pharmaceutiques. 2023. ffdumas-04146748f