"The First Thousand Days" Define a Fetal/Neonatal Neurology Program.

Area of Science:

• Neuroscience
• Developmental Biology
• Genetics

Background:

• Gene-environment interactions profoundly influence brain development from conception.
• Critical/sensitive periods during the first 1,000 days are crucial for neuroplasticity.
• Maternal/placental/fetal (MPF) triad health impacts neonatal and child brain development.

Purpose of the Study:

• To identify trimester-specific mechanisms affecting the MPF triad and their impact on brain development.
• To understand how maladaptive MPF interactions lead to brain malformations and lesions.
• To improve early detection and diagnosis of neurological disorders in neonates and children.

Main Methods:

• Applying a fetal/neonatal program (FNNP) perspective to analyze trimester-specific mechanisms.
• Investigating processes like maternal immune activation and ischemic placental syndromes.
• Utilizing systems-biology analyses and the principle of ontogenetic adaptation for diagnosis.

Main Results:

• Maladaptive MPF interactions impair progenitor neuronal/glial populations.
• Destructive fetal brain lesions are linked to ischemic placental syndromes.
• The majority of neurologic disorders are detected after 2 years, often without prior indication.

Conclusions:

• Early-life interventions based on trimester-specific mechanisms can prevent or mitigate neurological damage.
• An FNNP approach enhances early diagnosis and therapeutic strategies.
• Reducing the early-life neurologic disease burden benefits individuals across the lifespan and future generations.