Support from the Start: effective programmes in pregnancy
| Pages | 8-17 |
| Published date | 16 March 2012 |
| DOI | https://doi.org/10.1108/17466661211213634 |
| Date | 16 March 2012 |
| Author | Vivette Glover,Carole Sutton |
| Subject Matter | Education,Health & social care,Sociology |
Support from the Start: effective
programmes in pregnancy
Vivette Glover and Carole Sutton
Abstract
Purpose – The purpose of this paper is to update the evidence for the long-term effects of the fetal
environment on the later antisocial behaviour of the child, and possible interventions.
Design/methodology/approach – The authors presenta literature reviewof recent research onthe topic.
Findings – Recent research confirms and extends previous conclusions. The emotional state, alcohol
use, smoking and drug consumption of the mother during pregnancy all increase the risk of the child
developing antisocial behaviour. Prenatal anxiety may contribute 10-15 per cent of the attributable load
to behavioural outcomes. The Nurse Family Partnership programme remainsthe only intervention to start
in pregnancy and show a long-term reduction in the child’santisocial behaviour. However, severalother
interventions are likely to be helpful.
Originality/value – Stress, anxiety and depression during pregnancy are frequently undetected by
health professionals and left untreated. Programmes to help with this, together with the reduction of
smoking and alcohol consumption, should help reduce later criminal behaviour.
Keywords Pregnancy, Prenatal, Stress, Fetus, Children, Neurodevelopment
Paper type Literature review
Introduction
It is increasingly clear that the time in the womb is important for later health and for
vulnerability to later disease and disorders. The organs, including the brain, are being
formed, and how they are formed is quite susceptible to environmental influence. The
science of epigenetics is showing some of the molecular mechanisms by which such fetal
programming comes about, and how such changes can last throughout the lifetime. If we
want the best outcomes for our children we need to start in pregnancy. Once epigenetic
changes and specific neural pathways in the brain are formed they can be hard to alter.
Although it is possible to help children with neurodevelopmental problems such as attention
deficit hyperactivity disorder (ADHD), conduct disorder or learning difficulties, all of which
lead to later antisocial and criminal behaviour, it can be difficult. It is much better to prevent
such problems arising in the first place, and the time to start is before the child is born.
It has been known for centuries that exposure to alcohol can affect fetal development. The
work of Barker (2007) and his colleagues during the last 20 years has demonstrated that the
way the fetus grows in the womb can cause vulnerability to physical disease, including
cardiovascular problems, later in life. It is now clear that the emotional state of the mother
during pregnancy is also very important for the development of the fetal brain and later risk
for antisocial behavior. Most of this work has been done in the last ten years, much of it since
the publication of Support from the Start (Sutton et al., 2004). In this paper we examine the
evidence for prenatal effects on the later child, either because the exposed children may
need extra support or because there may be opportunities for intervention during
pregnancy.We then consider some strategies and promising interventions for reducing risk.
Throughout we draw particularly on new evidence and publications since 2004.
PAGE 8
j
JOURNAL OF CHILDREN’S SERVICES
j
VOL. 7 NO. 1 2012, pp. 8-17, QEmerald Group Publishing Limited, ISSN 1746-6660 DOI 10.1108/17466661211213634
Vivette Glover is Professor
of Perinatal Psychobiology
in the Department of
Surgery and Cancer,
Imperial College London,
London, UK.
Carole Sutton is a Visiting
Senior Research Fellow in
the Division of Psychology,
De Montfort University,
Leicester, UK.
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