Infant Development Clinical Trial
Official title:
Maternal Adversity, Vulnerability and Neurodevelopment
Maternal Adversity Vulnerability and Neurodevelopment (MAVAN) project is a prospective community-based, pregnancy and birth cohort of Canadian mother-child dyads. The main objective of MAVAN project is to examine the pre- and postnatal influences, and their interaction, in determining individual differences in children development. The MAVAN project is designed to examine the consequences of fetal adversity as a function of the quality of the postnatal environment, focusing on mother-infant interactions.
In 2003 the Canadian Institutes of Health Research (CIHR) funded an ambitious and
internationally unique study on the development of individual differences in vulnerability
for mental illness. Increasing evidence indicates that many forms of mental illness as well
as diabetes and cardiovascular disease are best considered as developmental disorders where
vulnerability emerges as a function of genetic and epigenetic events. Frank pathology then
develops as a function of the continuous interaction between underlying vulnerability and
prevailing environmental triggers. The critical question is that of understanding the
mechanisms by which specific forms of gene x environment interactions in perinatal life
define the level of vulnerability/resistance to illness.
Maternal adversity during fetal life including maternal stress (as well as depression), low
social support, poor maternal nutrition, and tobacco/alcohol consumption predict both preterm
labour and intrauterine growth restriction. These birth outcomes, in turn, represent major
epidemiological risk factors for heart disease, diabetes, and depression in adulthood, and
neurodevelopmental impairments in children. Postnatal maternal adversity compromises maternal
care/behaviour and infant development, and predicts increased risk for obesity, heart
disease, attentional deficit disorders (ADD), drug abuse, and depression. Despite the
enormous potential for the interaction of prenatal and postnatal influences, research has
largely been restricted to the effects of events occurring during only one developmental
period which, among other things, ignores the potential importance of 'protective' factors
operating at later stages in life. Moreover, the underlying mechanisms by which perinatal
adversity might directly affect neurocognitive development have been very poorly studied.
The investigators proposed an innovative research program that focuses on child development
using a longitudinal, within-subject design examining neural and cognitive/emotional outcomes
as a function of genomic and epigenomic factors. These studies focus on 500 mother-infant
dyads drawn from two human studies (Montreal & Hamilton). Assessment of maternal wellbeing
and infant development (cognition, socio-emotional development, temperament, and brain
structure) trajectories are undertaken from mid-pregnancy until 10 years of age. Genomic and
epigenomic approaches were used to assess genetic vulnerability in these populations using a
GWAS approach. This represents the first longitudinal study linking
neurocognitive/behavioural function with structural neurodevelopment through neuroimaging and
genetic vulnerability in humans, in the presence or absence of maternal adversity. The
ability to identify postnatal events that serve to reverse a condition of vulnerability has
enormous implications for the development of prevention /intervention programs reducing the
future rates of a broad spectrum of chronic illnesses.
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