Prenatal Influences on Child Development

PRENATAL FOUNDATIONS: Fetal Programming of Health and Development

Elysia Poggi Davis and Ross A. Thompson

The fetal programming and developmental origins of disease models suggest that experiences that occur before birth can have consequences for physical and mental health that persist across the lifespan. Development is more rapid during the prenatal period as compared to any other stage of life. This introductory article considers evidence that fetal exposure to stress and stress hormones influences stress and emotional regulation, cognitive functioning, and brain development during infancy and childhood. The authors consider implications for intervention and future research directions.

UNDERSTANDING PREGNANCY ANXIETY: Concepts, Correlates, and Consequences

Christine M. Guardino and Christine Dunkel Schetter

Pregnancy anxiety is a particular emotional state tied to pregnancy-specific concerns, such as worries about the health of the baby and childbirth. A growing body of research demonstrates that pregnancy anxiety is an important risk factor for preterm birth and other adverse birth and child development outcomes. This article defines and describes the concept of pregnancy anxiety, provides a summary of evidence linking pregnancy anxiety to outcomes, and identifies characteristics of women and their pregnancies that contribute to high levels of pregnancy anxiety. The authors also discuss possible clinical implications and interventions to reduce pregnancy anxiety.

HOW PRENATAL DEPRESSION, ANXIETY, AND STRESS MAY AFFECT CHILD OUTCOME: The Placenta and Child Development

Vivette Glover, T. G. O’Connor, K. O’Donnell, and Lauren Capron

There is good evidence that if a woman is depressed, anxious, or stressed while she is pregnant, then there is an increased risk that her child will have emotional, behavioral, or cognitive problems. Her own biology must cause these effects, but it is not known how. One important line of research suggests that the function of the placenta changes in response to maternal mood in ways that may allow more of the stress hormone cortisol, and the neurotransmitter serotonin to pass through to the developing fetus and affect brain development. A better understanding of these mechanisms should eventually help researchers devise interventions to improve child development and health.

HOW MOTHERHOOD AND POVERTY CHANGE THE BRAIN

Pilyoung Kim and Hannah Bianco

Poverty-associated chronic stress is a serious threat not only to a mother’s mental health but also to maternal functioning. Recent neuroimaging studies suggest that a mother’s brain undergoes dynamic changes to support her transition to parenthood, including better emotion regulation and heightened sensitivity to infants. However, we propose that the chronic stress experienced by low-income mothers may result in damage to such adaptive neural changes, and in turn increase risk for postpartum depression and harsh parenting. Understanding of the neurobiological risk markers involved may help develop more precise interventions and treatments aimed at improving low-income mothers’ psychological health and mother–infant relationships.

UNDERSTANDING AND ALLEVIATING CULTURAL STRESSORS AND HEALTH DISPARITIES IN THE PERINATAL OUTCOMES OF MEXICAN-AMERICAN WOMEN

Kimberly D’Anna-Hernandez and Kendra Dyanne Rivera

Women from minority populations, such as Mexican-American women, face unique social and cultural stressors that are different from men and women in the majority population. These differences have important consequences for the physical and mental health of pregnant mothers and contribute to perinatal health inequalities. As the population in the U.S. continues to diversify, the health care community is becoming more aware of how stressors affect demographic populations differently. Particularly for Mexican-American women, acculturation to mainstream culture poses risks for the mother and child that may be driven by acculturative stress. Protective cultural practices need to be identified in research and practice to promote healthier maternal outcomes for vulnerable populations.

FETAL NEUROBEHAVIORAL DEVELOPMENT AND THE ROLE OF MATERNAL NUTRIENT INTAKE AND PSYCHOLOGICAL HEALTH

Marisa Spann, Jennifer Smerling, Hanna Gustafsson, Sophie Foss, and Catherine Monk

Measuring and understanding fetal neurodevelopment provides insight regarding the developing brain. Maternal nutrient intake and psychological stress during pregnancy each impact fetal neurodevelopment and influence childhood outcomes and are thus important factors to consider when studying fetal neurobehavioral development. The authors provide an overview of fetal neurobehavioral development and the unique contribution of nutrition and psychological stress on the fetus during pregnancy.

FETAL PROGRAMMING INFORMING FEDERAL POLICY: A Look Toward the Future

David W. Willis

There have been revolutionary advances in the last decade in researchers’ understanding of the genesis of life course health from the critical formative experiences before birth. Even more striking are the factors in a mother’s developmental and nutritional history and experience that shape her health, a healthy pregnancy and delivery, and the future life course health and development of her offspring. With emerging and irrefutable epidemiological data in support of the fetal programming and developmental origins of disease model, current major national policies and investments in the U.S. are ever more essential to support the health, nutrition, and well-being of mothers before, during, and after pregnancies—not only for their own benefit, but more important, for that of their babies—the country’s future citizens.

PERSPECTIVES—A PLACE TO BEGIN: Engaging Parents With Their Baby Before Birth

Linda Gilkerson and Nick Wechsler

The Community-Based Family Administered Neonatal Activities (CB–FANA; Cardone, Gilkerson, & Wechsler, 2005) offers home visitors and expectant parents a new way to be together during the unfolding months before birth. The CB- FANA is used across Illinois by the Ounce of Prevention Fund to prepare home visitors and doulas for their work with mothers and fathers and to help them become emotionally available and attuned parents and help them engage with their baby beginning before birth.