A nurse is educating a pregnant client about striae gravidarum. Which statement best explains the pathophysiology and risk factors associated with the development of these skin changes during pregnancy?

A. Striae gravidarum can appear in the second or third trimester, not exclusively in the third. Their severity is strongly influenced by genetic predisposition, hormonal changes, and the degree of skin stretching rather than fetal growth. B. Striae gravidarum result from dermal tearing as the skin stretches beyond its elastic capacity. Hormones such as cortisol and estrogen reduce fibroblast activity and collagen strength, predisposing the skin to rupture and forming stretch marks. C. Striae gravidarum are caused by autoimmune destruction of dermal tissue, commonly seen in There is no autoimmune mechanism involved in the development of striae. They are purely structural and hormonal changes in the skin rather than immune-mediated conditions. D. Striae actually result from decreased dermal elasticity and collagen integrity. Estrogen and glucocorticoids impair collagen synthesis, leading to thinning and tearing of the dermal layer instead of thickening.