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==During Antenatal Period==
 
==During Antenatal Period==
 
===Physical Factors===
 
===Physical Factors===
Role of [[panchamaha bhuta]]  
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'''Role of [[panchamaha bhuta]]'''
In embryo (garbha), division (vibhajana), metabolism (pachana), moistening (kledana), solidification (samhanana) and increase in size (vivardhana) are done by [[vaju]], [[agni]], [[jala]], [[pridhvi ]], and [[akasha]] respectively.[Su.Sa. Sharira Sthana 5/3]
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In embryo (garbha), division (vibhajana), metabolism (pachana), moistening (kledana), solidification (samhanana) and increase in size (vivardhana) are done by [[vaju]], [[agni]], [[jala]], [[pridhvi]], and [[akasha]] respectively.[Su.Sa. Sharira Sthana 5/3]
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Acharya Bhela specifically mentions the role of [[vayu]] and [[akasha]] in the birth of a child having abnormal anatomy.[ Bhela Sa Sharira Sthana 3/15-16].
 
Acharya Bhela specifically mentions the role of [[vayu]] and [[akasha]] in the birth of a child having abnormal anatomy.[ Bhela Sa Sharira Sthana 3/15-16].
Role of [[Dosha]]
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Vitiation of all the three doshas during pregnancy is the ultimate cause of congenital disorders. [A. H. Sharira Sthana 1/6] Among them [[vata]] is having the main role as it is the controller of all kind of activities and especially the anatomical formation (akruti)of embryo(garbha) is brought out by [[vayu]][Cha. Sa. Sutra sthana 12/8], [Su. Sa. Sharira Sthana 2/50-52]
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'''Role of [[Dosha]]'''
Diet and life style of the mother:  
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Congenital abnormalities due to use of diet or mode of life described under the factors adversely affecting the pregnancy outcome (garbhopaghatakara bhavas) are mentioned in the table. [Cha. Sa. Sharira Sthana 8/21]
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Vitiation of all the three doshas during pregnancy is the ultimate cause of congenital disorders. [A. H. Sharira Sthana 1/6] Among them [[vata]] is having the main role as it is the controller of all kind of activities and especially the anatomical formation (akruti)of embryo(garbha) is brought out by [[vayu]][Cha. Sa. [[Sutra sthana]] 12/8], [Su. Sa. Sharira Sthana 2/50-52]
Dietetics or mode of life Effect on the fetus or child
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Squatting or sitting in abnormal position, suppression of urges of defecation, urination or flatus, improper and excessive exercise, use of pungent, hot edibles or less quantity of food Intrauterine death of fetus /premature delivery /abortion / growth restriction of fetus.
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'''Diet and life style of the mother:'''
Trauma and compression (on lower abdomen), peeping or falling in deep pit or well, riding in jerking vehicle, listening to unpleasant words. Premature delivery or abortion.
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Sleeping in supine position with stretched extremities. Umbilical cord encircles the neck and
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Congenital abnormalities due to use of diet or mode of life described under the factors adversely affecting the pregnancy outcome (garbhopaghatakara bhavas) are mentioned in the table. [Cha. Sa. [[Sharira Sthana]] 8/21]
Sleeping uncovered in open place or night walking Insane or extravagant child
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{| class="wikitable"
Oral or physical strife or pugnacious Epileptic child
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|-
Over indulgence in sex Deformed, impudent or lazy and henpecked
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|Dietetics or mode of life || Effect on the fetus or child
Always distressed or grieved Poltroon, slender, short lived, having less digestive power etc.
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|-
Psychologically malevolent or constantly worried. Nature of troubling others, jealous and henpecked.
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|Squatting or sitting in abnormal position, suppression of urges of defecation, urination or flatus, improper and excessive exercise, use of pungent, hot edibles or less quantity of food || Intrauterine death of fetus /premature delivery /abortion / growth restriction of fetus.
Thief or robber. Industrious, spiteful, idle
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|-
Intolerant Furious, deceitful, insidious, calumnious.
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|Trauma and compression (on lower abdomen), peeping or falling in deep pit or well, riding in jerking vehicle, listening to unpleasant words.
Over sleepy Sleepy, ignorant and possess less digestive power
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||Premature delivery or abortion.
Using wine daily Over thirsty, short memory and flicking mind.
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|-
Often use of meat of iguana. Suffers from bladder stone, gravel or slow stream of urine.
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|Sleeping in supine position with stretched extremities.||Umbilical cord encircles the neck  
Often use of hog’s meat(pork) Red eyes, rough body hairs, and obstructed breathing or snoring.
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|-
Daily use of fish Fixed eyes or delayed blinking of the eye lids
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|Sleeping uncovered in open place or night walking ||Insane or extravagant child
Excessive use of sweet articles daily(except milk) Suffers from urinary disorders and diabetes mellitus (prameha), obese or dumb child
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|-
Excessive use of sour articles daily Suffers from bleeding disorders (raktapitta),skin and eye disorders
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|Oral or physical strife or pugnacious ||Epileptic child
Excessive use of salty articles daily Early wrinkling ,graying of hairs and baldness
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|-
Excessive use of pungent articles daily Weak, possess less quantity of semen(shukra) , infertile
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|Over indulgence in sex || Deformed, impudent or lazy and henpecked
Excessive use of bitter articles daily Suffers from emaciation or edema, weak , scraggy and less digestive power
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|-
Excessive use of astringent articles daily Swarthy, suffers from flatulence (anaha) and eructation (udavarta)
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|Always distressed or grieved || Poltroon, slender, short lived, having less digestive power etc.
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|-
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|Psychologically malevolent or constantly worried.||Nature of troubling others, jealous and henpecked.
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|-
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|Thief or robber ||Industrious, spiteful, idle
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|-
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|Intolerant || Furious, deceitful, insidious, calumnious.
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|-
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|Over sleepy || Sleepy, ignorant and possess less digestive power
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|-
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|Using wine daily ||Over thirsty, short memory and flicking mind.
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|-
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|Often use of meat of iguana.||Suffers from bladder stone, gravel or slow stream of urine.
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|-
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|Often use of hog’s meat(pork) ||Red eyes, rough body hairs, and obstructed breathing or snoring.
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|-
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|Daily use of fish || Fixed eyes or delayed blinking of the eye lids
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|-
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|Excessive use of sweet articles daily(except milk)|| Suffers from urinary disorders and diabetes mellitus (prameha), obese or dumb child
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|-
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|Excessive use of sour articles daily || Suffers from bleeding disorders (raktapitta),skin and eye disorders
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|-
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|Excessive use of salty articles daily || Early wrinkling ,graying of hairs and baldness
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|-
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|Excessive use of pungent articles daily || Weak, possess less quantity of semen(shukra) , infertile
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|-
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|Excessive use of bitter articles daily || Suffers from emaciation or edema, weak , scraggy and less digestive power
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|-
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|Excessive use of astringent articles daily || Swarthy, suffers from flatulence (anaha) and eructation (udavarta)
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|}
    
Acharya Vagbhata mentions the effect of diet vitiating particular [[dosha]] taken by the mother. [Ash Sa Sharira Sthana 2/54-56]
 
Acharya Vagbhata mentions the effect of diet vitiating particular [[dosha]] taken by the mother. [Ash Sa Sharira Sthana 2/54-56]
Type of Diet Effect on Child
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[[Vata]] vitiating diet Makes the child deaf, dumb, idiot, having hoarse or nasal voice, lame, humpbacked, dwarf, possessing less or more number of body parts, other abnormalities arising due to [[vata]].
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{| class="wikitable"
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|-
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!Type of Diet !! Effect on Child
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|-
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|[[Vata]] vitiating diet || Makes the child deaf, dumb, idiot, having hoarse or nasal voice, lame, humpbacked, dwarf, possessing less or more number of body parts, other abnormalities arising due to [[vata]].
 
Ex- Contracted ear pinna(kuchikarnaka)
 
Ex- Contracted ear pinna(kuchikarnaka)
[[Pitta]] vitiating diet Baldness, premature graying of hairs, absence of hair on face, tawny colour of skin, nail and hairs, other abnormalities of pitta
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|-
[[Kapha]] vitiating diet skin disorders(kushta and kilasa),congenital presence of teeth
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|[[Pitta]] vitiating diet|| Baldness, premature graying of hairs, absence of hair on face, tawny colour of skin, nail and hairs, other abnormalities of pitta
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|-
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|[[Kapha]] vitiating diet || skin disorders(kushta and kilasa),congenital presence of teeth
 
vitiligo (shwitra)* and anaemia (pandu)*
 
vitiligo (shwitra)* and anaemia (pandu)*
 
Tridosha vitiating diet Mixed presentation of all these abnormalities.
 
Tridosha vitiating diet Mixed presentation of all these abnormalities.
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|}
 
*[A. H. Sharira Sthana 1/48]
 
*[A. H. Sharira Sthana 1/48]
Effect of maternal diseases upon the fetus
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'''Effect of maternal diseases upon the fetus'''
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Whichever the part of the pregnant lady’s body is afflicted either by vitiation of [[doshas ]]or by trauma, the identical part of the fetal body also suffers from the same trouble.[ Su Sa Sharira Sthana 3/17]
 
Whichever the part of the pregnant lady’s body is afflicted either by vitiation of [[doshas ]]or by trauma, the identical part of the fetal body also suffers from the same trouble.[ Su Sa Sharira Sthana 3/17]
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Maternal autoantibodies can cross the placenta and cause fetal damage. For example, fetal thyroid goiter can be developed in response to maternal Graves' disease.  
 
Maternal autoantibodies can cross the placenta and cause fetal damage. For example, fetal thyroid goiter can be developed in response to maternal Graves' disease.  
Environmental/Epigenetic Factors:
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Time factor(kala dosha) [Cha. Sa. Sharira Sthana 2/29]
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'''Environmental/Epigenetic Factors:'''
Nutritional and intrauterine environment [Cha. Sa. Sharira Sthana 2/29]
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Psychological and behavioral Factors:
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*Time factor(kala dosha) [Cha. Sa. [[Sharira Sthana]] 2/29]
Improper diet and lifestyle of mother(ahara –vihara dosha)[Cha. Sa. Sharira Sthana 2/29]
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Not satisfying the longings of pregnant lady(douhruda)[Su. Sa.  Sharira Sthana 2/50-52]
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*Nutritional and intrauterine environment [Cha. Sa. [[Sharira Sthana]] 2/29]
The psychological and cognitive development of fetus depends on the psychological status of mother and father.[ A. S. Sharira Sthana 1/66]
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Effect of non-fulfillment of longings/desires of mother during pregnancy (dauhruda vimanana):
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'''Psychological and behavioral Factors:'''
The desires of the fetus are expressed through mother and her longings (dauhruda) should always be fulfilled. Any negligence or non-fulfillment can cause abnormalities or even death of the fetus. Suppression of desires vitiates [[vayu]], which moves in the body of fetus and produces various diseases, abnormalities or even death. [Cha. Sa. Sharira Sthana 4/25].
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*Improper diet and lifestyle of mother(ahara –vihara dosha)[Cha. Sa. [[Sharira Sthana]] 2/29]
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*Not satisfying the longings of pregnant lady(douhruda)[Su. Sa.  Sharira Sthana 2/50-52]
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*The psychological and cognitive development of fetus depends on the psychological status of mother and father.[ A. S. Sharira Sthana 1/66]
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'''Effect of non-fulfillment of longings/desires of mother during pregnancy (dauhruda vimanana):'''
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The desires of the fetus are expressed through mother and her longings (dauhruda) should always be fulfilled. Any negligence or non-fulfillment can cause abnormalities or even death of the fetus. Suppression of desires vitiates [[vayu]], which moves in the body of fetus and produces various diseases, abnormalities or even death. [Cha. Sa. [[Sharira Sthana]] 4/25].
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Acharya Sushruta opines that non-fulfillment of desires produces the fetus which is hump-backed, crooked armed and legged, idiot, dwarf, having disfigured eyes or there is absence of eyes. Non fulfillment can harm both the mother and the fetus, specially suppression of desires related to specific sensory or motor organ (indriya) produces abnormality of corresponding sensory or motor organ (indriya)of the fetus.[Su. Sa. Sharira Sthana  3/18-21].
 
Acharya Sushruta opines that non-fulfillment of desires produces the fetus which is hump-backed, crooked armed and legged, idiot, dwarf, having disfigured eyes or there is absence of eyes. Non fulfillment can harm both the mother and the fetus, specially suppression of desires related to specific sensory or motor organ (indriya) produces abnormality of corresponding sensory or motor organ (indriya)of the fetus.[Su. Sa. Sharira Sthana  3/18-21].
Various studies indicate that mental illness and neurocognitive decline are prevalent co-morbidities in the adolescent and adult population with Congenital Heart Diseases (CHD).
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Various studies indicate that mental illness and neurocognitive decline are prevalent co-morbidities in the adolescent and adult population with Congenital Heart Diseases (CHD).
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==During Intra-partum Period==
 
==During Intra-partum Period==
 
Consequences of inappropriate bearing down efforts by the mother:
 
Consequences of inappropriate bearing down efforts by the mother:
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