smoking and alcohol and drug use, exposure to neurotoxic substances, maternal depression or stress, low birth weight, and perinatal insults. Interventions that prevent these conditions have the potential to prevent many subsequent problems for the child. For example, recent evidence suggests that reduced exposure of pregnant mothers to lead results in reduced total arrests and arrests for violent crimes of their children at ages 19-24 (Wright, Dietrich, et al., 2008).

Universal preventive measures that have been adopted throughout the United States include the removal of lead from paint and gasoline. Another universal preventive measure (U.S. Environmental Protection Agency, 2004) has been warning pregnant women or those anticipating conception about the high methyl mercury content of fish at the top of the marine food chain. Prenatal exposure to this heavy metal has been linked to adverse cognitive and behavioral childhood outcomes (Gao, Yan, et al., 2007; Transande, Schechter, et al., 2006). However, some studies have reported increases in postpartum depression (Hibbeln, 2002) and reductions in children’s IQ (Hibbeln, Davis, et al., 2007) as a result of reduced seafood intake, suggesting that this area may warrant further study.

Preterm Births and Prenatal Care

The rate of preterm births in the United States has increased from approximately 8 to 12.5 percent over the past two decades, and attempts to prevent or reduce their frequency (such as by providing access to prenatal care) have been unsuccessful (Institute of Medicine, 2007c). Reducing preterm births remains a significant opportunity for prevention of MEB disorders in childhood.

Half of all mothers and infants in the United States are enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federal program that serves pregnant and lactating women and children up to age 5 (see http://www.fns.usda.gov/pdWIC_Monthly.htm). Participation in WIC has been associated with improved birth outcomes, such as longer pregnancies, fewer preterm births, decreased prevalence of anemia in childhood, and improved cognitive outcomes (Ryan and Zhou, 2006). Although it is likely that the WIC program contributes to the promotion of mental health of children and youth, the magnitude of this contribution is unknown.

Peripartum Depression

Changes in sleep, appetite, weight, energy level, and physical comfort in women during pregnancy and postpartum can cause significant emotional strain. Screening for peripartum (prenatal and postpartum) depression is



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