Structural and functional changes to fetal organs, including the brain, among female children exposed to natural disaster pre-birth has been proposed as an explanation for an increased risk of internalized symptoms characteristic of anxiety disorders. Changes include:
- Greater decrease in placental 11B-HSD2 (an enzyme that converts active cortisol to the inactive cortisone) following maternal stress in female fetuses
-  Stronger fronto-limbic connectivity in response to prenatal stress
- Larger right amygdala volume when exposed to prenatal stress

Proposed Reasons for Sex Differences in Anxiety Disorders Among Preschool-Aged Children Exposed to Natural Disasters

Exposure to prenatal stress is primarily related to an increase in anxiety in females. Female offspring have been found to have greater internalizing symptoms, typical of anxiety disorders.

Cleveland State University

Children exposed to natural disasters prior to being born are an over 5-fold increased risk for anxiety disorders when compared to their non-exposed peers.

Risk of Anxiety Disorders in Preschool-Aged Children Exposed to Natural Disasters In Utero

Nomura, Y., Newcorn, J. H., Ginalis, C., Heitz, C., Zaki, J., Khan, F., Nasrin, M., Sie, K., DeIngeniis, D., &amp; Hurd, Y. L. (2022). Prenatal exposure to a natural disaster and early development of psychiatric disorders during the preschool years: Stress in pregnancy study. Journal of Child Psychology and Psychiatry. https://doi.org/10.1111/jcpp.13698 

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