Fetal brain development: The role of maternal nutrition, exposures and behaviors

Abstract

Perinatal events and postnatal environmental factors are often the focus when identifying neurodevelopmental risk factors. However, the in utero environment may be an equally important factor for fetal brain development. The objective of this article is to describe in utero environmental factors that may impact fetal brain development and subsequent neurodevelopmental outcome. This is a literature review to examine maternal nutrition, exposures, and behaviors that impact the in utero environment and, consequently, fetal brain development. A medline search of relevant articles published over the last 25 years was performed utilizing various keywords such as fetal brain development, individual vitamin/minerals, and specific exposures chosen by the authors that have been shown to impact in utero neurodevelopment. This article reviews important maternal nutritional deficiencies and toxin exposures that may negatively impact fetal brain development. Positive exposures to maternal voice, music, and exercise are also reviewed. Fetal brain development is a complex and intricate process. Neurodevelopmental delays detected postnatally are often multifactorial. In utero insults, postnatal illness, socioeconomic factors, and developmental environment may all attribute to poor outcomes. It is often difficult or impossible to determine which factor or factors contribute the most to morbidity. While reports on developmental delays often focus on clinical risk factors such as preterm birth or maternal/neonatal infection, perinatal events such as birth asphyxia, or known postnatal environmental factors such as low socioeconomic status or parental neglect, it is important to remember that in utero insults may be equally responsible. This article reviews early neurological development and a selection of various maternal exposures and behaviors that may impact the fetal brain during this critical developmental period.