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Moving the dial on prenatal stress mechanisms of neurodevelopmental vulnerability to mental health problems: A personalized prevention proof of concept
Developmental Psychobiology ( IF 1.8 ) Pub Date : 2020-11-22 , DOI: 10.1002/dev.22057
Lauren S Wakschlag 1, 2 , Darius Tandon 1, 2, 3 , Sheila Krogh-Jespersen 1, 2 , Amelie Petitclerc 1, 2 , Ashley Nielsen 1, 2 , Rhoozbeh Ghaffari 2, 4 , Leena Mithal 4, 5 , Michael Bass 1, 2 , Erin Ward 1, 2, 3 , Jonathan Berken 2, 6, 7 , Elveena Fareedi 1, 2 , Peter Cummings 1, 2 , Karen Mestan 2, 6, 8 , Elizabeth S Norton 2, 9 , William Grobman 2, 10 , John Rogers 2, 4 , Judith Moskowitz 1, 2 , Nabil Alshurafa 2, 11, 12
Affiliation  

Prenatal stress exposure increases vulnerability to virtually all forms of psychopathology. Based on this robust evidence base, we propose a “Mental Health, Earlier” paradigm shift for prenatal stress research, which moves from the documentation of stress-related outcomes to their prevention, with a focus on infant neurodevelopmental indicators of vulnerability to subsequent mental health problems. Achieving this requires an expansive team science approach. As an exemplar, we introduce the Promoting Healthy Brain Project (PHBP), a randomized trial testing the impact of the Wellness-4-2 personalized prenatal stress-reduction intervention on stress-related alterations in infant neurodevelopmental trajectories in the first year of life. Wellness-4-2 utilizes bio-integrated stress monitoring for just-in-time adaptive intervention. We highlight unique challenges and opportunities this novel team science approach presents in synergizing expertise across predictive analytics, bioengineering, health information technology, prevention science, maternalfetal medicine, neonatology, pediatrics, and neurodevelopmental science. We discuss how innovations across many areas of study facilitate this personalized preventive approach, using developmentally sensitive brain and behavioral methods to investigate whether altering children's adverse gestational exposures, i.e., maternal stress in the womb, can improve their mental health outlooks. In so doing, we seek to propel developmental SEED research towards preventive applications with the potential to reduce the pernicious effect of prenatal stress on neurodevelopment, mental health, and wellbeing.

中文翻译:

调整神经发育易受心理健康问题影响的产前应激机制:个性化预防概念证明

产前压力暴露增加了对几乎所有形式的精神病理学的脆弱性。基于这一强有力的证据基础,我们提出了“心理健康,更早”的产前压力研究范式转变,从压力相关结果的记录转向预防,重点是婴儿神经发育指标对后续心理健康的脆弱性问题。实现这一目标需要广泛的团队科学方法。作为范例,我们介绍了促进健康大脑项目 (PHBP),这是一项随机试验,测试 Wellness-4-2 个性化产前减压干预对出生后第一年婴儿神经发育轨迹压力相关改变的影响。Wellness-4-2 利用生物综合压力监测进行适时的适应性干预。胎儿医学、新生儿学、儿科和神经发育科学。我们讨论了许多研究领域的创新如何促进这种个性化的预防方法,使用发育敏感的大脑和行为方法来调查改变儿童的不利妊娠暴露,即子宫内的母体压力,是否可以改善他们的心理健康前景。通过这样做,我们力求推动发展性 SEED 研究向预防性应用方向发展,从而有可能减少产前压力对神经发育、心理健康和幸福的有害影响。
更新日期:2020-11-22
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