Development & Parenting Begin before Birth: 

The Science — and Clinical Opportunities —of Fetal Origins of Future Child Health

The contexts in which people live — including socio-economic status, the built environment, exposure to climate change and minoritized treatment, and levels of social support — get ‘under the skin’ to affect long-term physical and mental health trajectories. For pregnant individuals, these experiences also are transmitted to the next generation, as has been rigorously demonstrated by decades of Developmental Origins of Adult Health and Disease (DOHaD) research. Applied to child mental health outcomes, there is a third pathway for the familial inheritance of risk for psychiatric illness beyond shared genes and the quality of parental care: the impact of pregnant women’s distress on fetal and infant brain–behavior development. This presentation will review epidemiological and observational clinical data demonstrating that maternal distress is associated with children’s increased risk for psychopathology. Several biological systems hypothesized to be mechanisms by which maternal distress affects fetal and child brain and behavior development also will be covered, as well as the two-generation clinical implications of DOHaD studies that focus on maternal distress. Development and parenting begin before birth.