Affiliations: Department of Newborn Services, George Washington
University Medical Center, Washington, USA
Note: [] Correspondence: An N. Massaro, MD, 900 23rd Street, NW Suite
G-2092, Washington DC 20037, USA. Tel: +1 202 715 5236; Fax: +1 202 715 354;
E-mail: [email protected]
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.
