Pregnancies under stress conditions are frequent and correlate with poorer obstetric and neonatal outcomes and long-term repercussions on the child's cognitive, emotional, and behavioural neurodevelopment and psychopathology. Different pathways have been studied for the utero programming of the fetus as a consequence of modifications of the feto-maternal environment under maternal stress conditions.The role of the placenta is emerging, including the mechanisms and consequences of placental adaptive responses and barrier alterations in fetal and placental programming. Placenta-derived serotonin is possible mediator of prenatal stress. An improved understanding of the effects of maternal stress/depression and selective serotonin reuptake inhibitor treatment on trophoblast development will provide novel pathways for preventive and therapeutic strategies. The development of effective prenatal and postpartum interventions to reduce maternal stress could prevent or modify some programmed changes and thus improve child outcomes.