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“The First Thousand Days” Define a Fetal/Neonatal Neurology Program

Gene–environment interactions begin at conception to influence maternal/placental/fetal triads, neonates, and children with short- and long-term effects on brain development. Life-long developmental neuroplasticity more likely results during critical/sensitive periods of brain maturation over these...

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Autor principal: Scher, Mark S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8365757/
https://www.ncbi.nlm.nih.gov/pubmed/34408995
http://dx.doi.org/10.3389/fped.2021.683138
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author Scher, Mark S.
author_facet Scher, Mark S.
author_sort Scher, Mark S.
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description Gene–environment interactions begin at conception to influence maternal/placental/fetal triads, neonates, and children with short- and long-term effects on brain development. Life-long developmental neuroplasticity more likely results during critical/sensitive periods of brain maturation over these first 1,000 days. A fetal/neonatal program (FNNP) applying this perspective better identifies trimester-specific mechanisms affecting the maternal/placental/fetal (MPF) triad, expressed as brain malformations and destructive lesions. Maladaptive MPF triad interactions impair progenitor neuronal/glial populations within transient embryonic/fetal brain structures by processes such as maternal immune activation. Destructive fetal brain lesions later in pregnancy result from ischemic placental syndromes associated with the great obstetrical syndromes. Trimester-specific MPF triad diseases may negatively impact labor and delivery outcomes. Neonatal neurocritical care addresses the symptomatic minority who express the great neonatal neurological syndromes: encephalopathy, seizures, stroke, and encephalopathy of prematurity. The asymptomatic majority present with neurologic disorders before 2 years of age without prior detection. The developmental principle of ontogenetic adaptation helps guide the diagnostic process during the first 1,000 days to identify more phenotypes using systems-biology analyses. This strategy will foster innovative interdisciplinary diagnostic/therapeutic pathways, educational curricula, and research agenda among multiple FNNP. Effective early-life diagnostic/therapeutic programs will help reduce neurologic disease burden across the lifespan and successive generations.
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spelling pubmed-83657572021-08-17 “The First Thousand Days” Define a Fetal/Neonatal Neurology Program Scher, Mark S. Front Pediatr Pediatrics Gene–environment interactions begin at conception to influence maternal/placental/fetal triads, neonates, and children with short- and long-term effects on brain development. Life-long developmental neuroplasticity more likely results during critical/sensitive periods of brain maturation over these first 1,000 days. A fetal/neonatal program (FNNP) applying this perspective better identifies trimester-specific mechanisms affecting the maternal/placental/fetal (MPF) triad, expressed as brain malformations and destructive lesions. Maladaptive MPF triad interactions impair progenitor neuronal/glial populations within transient embryonic/fetal brain structures by processes such as maternal immune activation. Destructive fetal brain lesions later in pregnancy result from ischemic placental syndromes associated with the great obstetrical syndromes. Trimester-specific MPF triad diseases may negatively impact labor and delivery outcomes. Neonatal neurocritical care addresses the symptomatic minority who express the great neonatal neurological syndromes: encephalopathy, seizures, stroke, and encephalopathy of prematurity. The asymptomatic majority present with neurologic disorders before 2 years of age without prior detection. The developmental principle of ontogenetic adaptation helps guide the diagnostic process during the first 1,000 days to identify more phenotypes using systems-biology analyses. This strategy will foster innovative interdisciplinary diagnostic/therapeutic pathways, educational curricula, and research agenda among multiple FNNP. Effective early-life diagnostic/therapeutic programs will help reduce neurologic disease burden across the lifespan and successive generations. Frontiers Media S.A. 2021-08-02 /pmc/articles/PMC8365757/ /pubmed/34408995 http://dx.doi.org/10.3389/fped.2021.683138 Text en Copyright © 2021 Scher. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Scher, Mark S.
“The First Thousand Days” Define a Fetal/Neonatal Neurology Program
title “The First Thousand Days” Define a Fetal/Neonatal Neurology Program
title_full “The First Thousand Days” Define a Fetal/Neonatal Neurology Program
title_fullStr “The First Thousand Days” Define a Fetal/Neonatal Neurology Program
title_full_unstemmed “The First Thousand Days” Define a Fetal/Neonatal Neurology Program
title_short “The First Thousand Days” Define a Fetal/Neonatal Neurology Program
title_sort “the first thousand days” define a fetal/neonatal neurology program
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8365757/
https://www.ncbi.nlm.nih.gov/pubmed/34408995
http://dx.doi.org/10.3389/fped.2021.683138
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