We can now project the potential impact of adversity in the womb on a child’s development and their risk of developing a mental illness as an adult.
Ludmer Centre researchers and an international team led by Dr Patricia P Silveira at the Douglas Mental Health University Institute and McGill University have created the first screening tool to link adverse conditions in the prenatal period to a wide range of mental health problems in childhood: the Cumulative Prenatal Adversity Score.
There is strong evidence for the importance of prenatal factors in determining the risk for later psychopathology. However, current screening tools tend to focus on extreme forms of adversity that are unique to the postnatal environment, such as, abuse (physical, emotional, sexual), household challenges (violence, substance abuse, mental illness, divorce) and neglect (physical, emotional). Many of these adversities are not applicable to the prenatal development period. Previous efforts to analyze the long-term effects of prenatal adversity on child development and mental health outcomes in adulthood also focused almost exclusively on a limited number of aspects of the prenatal environment, specifically birth weight or maternal mental health.
To address this, the researchers developed a cumulative index of prenatal adversity using data from a Canadian-based birth cohort study (MAVAN), which they then replicated in a Singapore-based birth cohort study (GUSTO). Prenatal adversities were computed using information on health during pregnancy, birth weight, gestational age, income, domestic violence/sexual abuse, marital strain, as well as maternal smoking, anxiety, and depression. The new Cumulative Prenatal Adversity Score not only fills in the prenatal gap, but it is also a better predictor of cognitive and socioemotional outcomes than any of the current single measures of prenatal adversity.
Advancing research into genetic risk
As the newly developed Cumulative Prenatal Adversity Score is not dependent upon any singular environmental factor but rather captures a global level of prenatal adversity, it presents a unique metric for advancing studies of genetic moderation of environmental conditions. To test this, the researchers developed a novel way to assess genetic risk by creating a score based on existing biological information. Using a complex bioinformatics approach, the authors converted the genetic data into a score that captures the gene network from the serotonin transporter gene in specific brain areas, such as the hippocampus, amygdala and prefrontal cortex. The function of this gene in these brain regions has been linked to depression and anxiety.
The Cumulative Prenatal Adversity Score interacted with the biologically informed genetic score to predict childhood behavior and risk for psychopathology. The findings of this study underscore the broad impact of prenatal adversity on neurodevelopmental outcomes and advance the methodology for neuroscientific information to address geneti risk.
Moving the tool to clinical application
The Cumulative Prenatal Adversity Score appears to provide a comprehensive picture of the prenatal environment and associates highly with child behavior, neurodevelopment, and risk for developing a mental illness in adulthood. To move the tool into clinical application, Dr Silveira’s international team is currently seeking funding to validate it in several existing large-scale birth cohort studies in Canada and worldwide.
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Read the article: PP Silveira, I Pokhvisneva, C Parent, S Cai, ASS Rema, BFP Broekman, A Rifkin-Graboi, M Pluess, KJ O’Donnell, and MJ Meaney. Cumulative prenatal exposure to adversity reveals associations with a broad range of neurodevelopmental outcomes that are moderated by a novel, biologically informed polygenetic score based on the serotonin transporter solute carrier family C6, member 4 (SLC6A4) gene expression. Access Volume 29, Issue 5 (Biological and Behavioral Effects of Early Adversity on Multiple Levels of Development) December 2017, pp. 1601-1617
Research collaboration: McGill University; Canadian Institute for Advanced Research; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR);Queen Mary University of London
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