Maternal Adversity, Vulnerability and Neurodevelopment
Condition: Mental Health Issue (E.G., Depression, Psychosis, Personality Disorder, Substance Abuse); Infant Development; Infant Behavior
MeSH terms: Substance-Related Disorders; Personality Disorders
Study type: Observational

Summary: 
      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.
    

Detailed description: 
      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.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Our community sample consisted of mothers recruited in Montréal (Québec) and Hamilton
        (Ontario), Canada, at 13 to 20 weeks' gestation. Participants were part of the Maternal
        Adversity, Vulnerability, and Neurodevelopment (MAVAN) study, which examines the
        development of individual differences in phenotypes associated with multiple forms of
        psychopathology. Mothers were first assessed during their pregnancy (∼26 weeks) and then
        followed at multiple time points that included home visits and laboratory sessions.
      
Keywords: Fetal growth retardation; Early adversity; Depressive Symptoms