Resumo
Objetivo: Compreender como o estresse materno durante a gestação influencia em modificações epigenéticas no eixo Hipotálamo-Hipófise-Adrenal (HHA) e suas repercussões no desenvolvimento psicológico da prole. Métodos: Trata-se de uma revisão integrativa da literatura, conduzida conforme as diretrizes PRISMA e a estratégia PICO. As buscas foram realizadas nas bases de dados PubMed e Portal de Periódicos CAPES, utilizando filtros de acesso aberto e artigos publicados nos últimos 10 anos. Foram incluídos ensaios clínicos e estudos observacionais que analisaram a metilação de genes fetais associada ao estresse materno gestacional e seus desfechos psicológicos no binômio mãe-bebê. Resultados: O estresse gestacional esteve associado a alterações epigenéticas em genes relacionados ao eixo HHA, especialmente NR3C1 e HSD11B2, comprometendo mecanismos placentários de proteção fetal e favorecendo maior exposição ao cortisol materno. Como consequência, observou-se predisposição da prole à hiper-reatividade hormonal, déficits de memória de trabalho, vulnerabilidade cognitiva e alterações comportamentais, variando conforme a janela gestacional de exposição e o sexo biológico fetal. Considerações finais: O estresse materno durante a gestação promove alterações epigenéticas capazes de impactar negativamente o neurodesenvolvimento fetal, evidenciando a necessidade de estratégias multiprofissionais voltadas à redução do estresse gestacional e à promoção da saúde mental materna e infantil.
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