Genes,
infection,
malnutrition, and other factors affecting fetal brain development are a major component of risk for a child's emotional development and later
mental illnesses, including
schizophrenia,
bipolar disorder, and
autism. Prenatal interventions to ameliorate that risk have yet to be established for clinical use. A systematic review of prenatal nutrients and childhood emotional development and later
mental illness was performed. Randomized trials of
folic acid,
phosphatidylcholine, and
omega-3 fatty acid supplements assess effects of doses beyond those adequate to remedy deficiencies to promote normal fetal development despite genetic and environmental risks.
Folic acid to prevent
neural tube defects is an example.
Vitamins A and D are currently recommended at maximum levels, but women's incomplete compliance permits observational studies of their effects.
Folic acid and
phosphatidylcholine supplements have shown evidence for improving childhood emotional development associated with later
mental illnesses.
Vitamins A and D decreased the risk for
schizophrenia and
autism in retrospective observations.
Omega-3 fatty acid supplementation during early pregnancy increased the risk for
schizophrenia and increased symptoms of
attention deficit hyperactivity disorder, but in later pregnancy it decreased childhood
wheezing and
premature birth. Studies are complicated by the length of time between birth and the emergence of
mental illnesses like
schizophrenia, compared with anomalies like facial clefts identified at birth. As part of comprehensive maternal and fetal
care, prenatal nutrient interventions should be further considered as uniquely effective first steps in decreasing risk for future psychiatric and other illnesses in newborn children. [AJP at 175: Remembering Our Past As We Envision Our Future July 1959: Longitudinal Observations of Biological Deviations in a Schizophrenic Infant Barbara Fish described the course of an infant born with fluctuating motor problems who developed
schizophrenia. (Am J Psychiatry 1959; 116:25-31 )].