Perinatal Pathways: What We Do


We study a possible third pathway by which risk for psychiatric disorders runs in families.

We investigate pregnant women’s experiences — depression, stress, medication use, and nutrition — as they shape fetal and infant neurobehavioral development, with implications for the future child’s mental health.
This research pushes the study of the mother–infant dyad to an earlier time, prior to birth, and considers psychological and biological factors as the mechanisms of maternal influence. We also conduct clinical trials of interventions during the perinatal period to improve women’s well-being for her, and for her child.

Our work is part of a burgeoning research domain known variously as the fetal origins of adult disease (FOAD) or the developmental origins of health and disease (DOHAD).

Based on animal models as well as epidemiological and observational samples, findings indicate that distress–based changes in pregnant women’s biology are associated with adverse cardiovascular, metabolic, as well as psychological effects in children and adults. In our FOAD studies, we focus on the perinatal period, the time when the maternal influence is thought to occur, and on children’s neurobehavioral development. We have four primary research questions carried out across a number of studies.

  • detect variation in fetal development associated with maternal distress, poor nutrition, and/or use of psychiatric medication and determine the relevance of these fetal characteristics to children’s future functioning
  • use MRI and EEG methodology to characterize differences in newborn brain development related to these prenatal exposures, and to determine the functional significance of these differences in terms of infant behavior and as they may be modified by postnatal factors such as maternal caregiving sensitivity
  • identify biological processes for the transmission of pregnant women’s experience to the fetus based on the following methodology: ambulatory assessment of blood pressure, HPA axis, immune activity; methylation in cord blood and placenta; mood and nutrition reports
  • determine if successful psychotherapeutic intervention with depressed and/or highly stressed pregnant women can improve women’s functioning and the neurobehavioral profile of the offspring, suggesting less risk of mental health disorders in the future.
In OUR APPROACH, we view:
  • psychology and biology as different levels of analysis having bi–directional influences;
  • development as a construction that reflects a succession of adaptations that evolve over time with change constrained by prior adaptation yet possible at many points.

And we are returning to what can seem obvious, that development begins before birth.