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. 2025 Sep;34(3):e70031.
doi: 10.1002/mpr.70031.

The Intergenerational Impact of Maternal Childhood Adversity on Child Behavior and Neurodevelopment: The Healthy MiNDS Protocol

Danilo Micali  1   2 , Ana Carolina Coelho Milani  3   4 , Camilla Salmeron  5 , Célia Araújo  1   3 , Aline Camargo Ramos  1   3 , Marcos Roberto Fanton  1   3 , Sara B VanBronkhorst  6 , Nitamar Abdala  7 , Ivaldo Silva  5 , Sintia Iole Belangero  1   2   3 , Cristiane S Duarte  6 , Jonathan Posner  8 , Andrea Parolin Jackowski  1   3
Affiliations

The Intergenerational Impact of Maternal Childhood Adversity on Child Behavior and Neurodevelopment: The Healthy MiNDS Protocol

Danilo Micali et al. Int J Methods Psychiatr Res. 2025 Sep.

Abstract

Objectives: Here we present Healthy MiNDS, a cohort of mothers and their newborns in São Paulo, Brazil, designed to investigate how maternal adverse childhood experiences (ACEs) intergenerationally affect child behavior and neurodevelopment, while exploring underlying biological mechanisms.

Methods: The study included seven encounters, beginning with the enrollment of women at 25-39 weeks of gestation from a low-resource area, based on their high or low exposure to ACEs. Their newborns were followed through the first 2 years of life. Biospecimens (e.g. maternal and cord blood, hair, saliva, placenta) were collected before/during childbirth and at follow-up visits. Newborns underwent non-sedated brain MRI scans and were regularly assessed for behavior, mother-child interactions, and home environment.

Results: We enrolled 626 mothers, with 60% of those who provided ACEs information (n = 603) reporting three or more ACEs, and 545 mother-child dyads. We obtained 303 MRI scans and 333 placental samples, among other biospecimens. Enrollment and the 6-month follow-up are complete, while the 14-, 18-, and 24-month visits are ongoing for active dyads.

Conclusion: The Healthy MiNDS data allows for testing associations between maternal ACEs, prenatal inflammation and stress, placental biology, and offspring brain-behavior development in a population highly exposed to ACEs.

Keywords: adverse childhood experiences; child behavior; fetal programming; neurodevelopment; offspring health.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

FIGURE 1
FIGURE 1
Visual overview of healthy MINDS design and procedures. Participants met our study team at enrollment during pregnancy, at childbirth, at pediatric appointments, and during follow‐up visits for the collection of biospecimens and clinical interviews. Black dots in the baseline section indicate from where biospecimens were collected. Numbered black circles indicate the number of months after childbirth at which each measurement was obtained. Follow‐up visits occurred at 6, 14, 18 and 24 months either at the participants' homes or at our research facilities. Images in the follow‐up section illustrate (part of) the protocols used to assess the indicated measurements. The main assessments related to mothers (red‐tagged), their children (orange‐tagged) and their secondary caretakers (blue‐tagged) at baseline and follow‐up visits are listed under “main measurements'' in the lower part of the figure. ACEs: adverse childhood experiences. MRI: magnetic resonance imaging. UNIFESP: Universidade Federal de São Paulo.
FIGURE 2
FIGURE 2
Profile of adverse childhood experiences (ACEs) and infant's biological sex in our sample. (A) Distribution of the number of ACEs reported by mothers (n = 603). Mothers reporting three or more ACEs in the CDC‐Kaiser ACE Questionnaire were categorized into the “high ACEs” group. (B) Proportion of infants' biological sex across the levels of maternal ACEs. The vertical line separates low (left) from high (right) maternal ACEs. F: female, M: male, NA: sex information not available.
FIGURE 3
FIGURE 3
Visual description of the analysis plan of healthy MiNDS.
See this image and copyright information in PMC

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