Prenatal Stress and Child Development

Ashley Wazana, M.D., FRCPC, is an Associate Professor at McGill University and FRQS senior clinician-scientist at the Jewish General Hospital (JGH). He is the co-director of a psychiatric day hospital for Early Childhood Disorders. Dr. Wazana completed his psychiatry training at McGill University and then proceeded to obtain his second M.Sc. in Epidemiology at Columbia. He had the privilege to start working on the MAVAN project with Michael Meaney more than 10 years ago as a principal investigator for psychopathology outcomes of this prenatal cohort. His research activities focus on identifying how the early environment, and specifically parent-child interactions, modifies the developmental risk characterized by prenatal adversity and genetic susceptibility to predict childhood psychopathology. He leads an international consortium of comparable prenatal cohorts (DREAM BIG), which examines, in multiple harmonized datasets, the same complex model of prediction of psychopathology from prenatal origins. Eszter Szekely, Ph.D., is a senior postdoctoral researcher at the Department of Psychiatry at McGill University. She obtained M.Sc. degrees in Child and Adolescent Psychology; Cognitive Neurosciences; and Epidemiology. Dr. Szekely received her doctoral degree from Erasmus University Medical Centre (Rotterdam, the Netherlands) on the Dutch Generation R Study. In her first postdoctoral training at the U.S. National Human Genome Research Institute, she combined large-scale genomic, longitudinal neuroimaging, behavioural and social network data to better understand the emergence of psychopathology, in particular ADHD. In her current research, Dr. Szekely continues to combine data from multiple levels of function to better understand the sex-specific effects of prenatal adversity on child mental health. Tim F. Oberlander, M.D., FRCPC, is the inaugural R. Howard Webster Professor in Brain Imaging and Child Development in the Department of Pediatrics, UBC, a clinician with the Child Development and Rehabilitation Program and attending physician with the BCCH Complex Pain Service. As a physician-scientist his work bridges developmental neurosciences and community child health. Dr. Oberlander's research seeks to understand how prenatal exposure to maternal mood disorders and exposure to antidepressants affects early development. A particular focus of his work studies how antidepressants (SSRIs) shape stress regulation and related behaviours during childhood. His research incorporates methods that extend from studies of molecular/genetic factors to population outcomes. His work provides strong evidence that both maternal mood and in utero exposure to SSRI antidepressants influences childhood behaviour. Increasingly, his work is showing that SSRI exposure only explains a proportion of behavioural outcomes, and key biological and maternal also shape pathways leading to both vulnerability and resiliency. Even in the face of adversity, some children do very well and the goal of Dr. Oberlander's work is to figure out how and why this happens.

Chapter 1. Introduction.- Chapter 2. The Developmental Meaning of Prenatal Maternal Stress.- Chapter 3. Transgenerational Transmission of Stress.- Chapter 4. Prenatal Programming at the Interface of the Placenta.- Chapter 5. Maternal Prenatal Stress and Offspring Immune Functioning.- Chapter 6. Epigenetic Effects of Prenatal Stress on the Offspring Stress Regulation System.- Chapter 7. The Developmental Microbiome at the Brain-Gut Interface.- Chapter 8. Prenatal Programming of Postnatal Plasticity.- Chapter 9. Gender Specific Effects of Prenatal Stress.- Chapter 10. Prenatal Programming of Neurodevelopment: Imaging and Structural Changes.- Chapter 11. Disentangling the Effects from Prenatal and Postnatal Maternal Stress.- Chapter 12. Statistical Modeling of Prenatal Environment by Gene Interactions.- Chapter 13. SSRI and Prenatal Stress Exposure.- Chapter 14. Stress and Resilience.- Chapter 15. Prenatal Experience, Trauma, and Culture.- Chapter 16. Early Prematurity as a Model for Early Intervention.- Chapter 17. Prenatal Stress and the Effect of Early Maternal Care.- Chapter 18. Looking Ahead: Prenatal and Perinatal interventions in Mental Health.