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Published Online: 14 November 2016

Fetal Origins of Mental Health: The Developmental Origins of Health and Disease Hypothesis

Abstract

The quality of fetal growth and development predicts the risk for a range of noncommunicable, chronic illnesses. These observations form the basis of the “developmental origins of health and disease” hypothesis, which suggests that the intrauterine signals that compromise fetal growth also act to “program” tissue differentiation in a manner that predisposes to later illness. Fetal growth also predicts the risk for later psychopathology. These findings parallel studies showing that antenatal maternal emotional well-being likewise predicts the risk for later psychopathology. Taken together, these findings form the basis for integrative models of fetal neurodevelopment, which propose that antenatal maternal adversity operates through the biological pathways associated with fetal growth to program neurodevelopment. The authors review the literature and find little support for such integrated models. Maternal anxiety, depression, and stress all influence neurodevelopment but show modest, weak, or no associations with known stress mediators (e.g., glucocorticoids) or with fetal growth. Rather, compromised fetal development appears to establish a “meta-plastic” state that increases sensitivity to postnatal influences. There also remain serious concerns that observational studies associating either fetal growth or maternal mental health with neurodevelopmental outcomes fail to account for underlying genetic factors. Finally, while the observed relation between fetal growth and adult health has garnered considerable attention, the clinical relevance of these associations remains to be determined. There are both considerable promise and important challenges for future studies of the fetal origins of mental health.

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Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 319 - 328
PubMed: 27838934

History

Received: 2 February 2016
Revision received: 26 July 2016
Accepted: 22 August 2016
Published online: 14 November 2016
Published in print: April 01, 2017

Keywords

  1. Developmental Programming
  2. DOHaD
  3. Antenatal Anxiety and Depression
  4. Prenatal Stress
  5. Perinatal Psychiatry

Authors

Details

Kieran J. O’Donnell, Ph.D.
From the Sackler Program for Epigenetics and Psychobiology, McGill University, Montreal; the Ludmer Centre for Neuroinformatics and Mental Health, Department of Psychiatry, McGill University, Montreal; and the Singapore Institute for Clinical Sciences, Singapore.
Michael J. Meaney, Ph.D.
From the Sackler Program for Epigenetics and Psychobiology, McGill University, Montreal; the Ludmer Centre for Neuroinformatics and Mental Health, Department of Psychiatry, McGill University, Montreal; and the Singapore Institute for Clinical Sciences, Singapore.

Notes

Address correspondence to Dr. Meaney ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

The Ludmer Foundation
Sackler Program for Epigenetics and Psychobiology
Canadian Institute for Advanced Research10.13039/100007631
Hope for Depression Research Foundation10.13039/100006346
Fondation Brain Canada10.13039/100009408
Supported by funding from the Sackler Foundation, the Ludmer Foundation, Brain Canada, and the Hope for Depression Research Foundation. Dr. O’Donnell is a Global Scholar of the Canadian Institute for Advanced Research Child and Brain Development Program.

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