PerinatalPathways Lab
Principal Investigator
Overview
Our research engages pregnant women and their babies, before and after birth, in research studies to ensure a future in which parents and children thrive from the very start.
For nearly 30 years, we have contributed to the scientific evidence showing that experiences during pregnancy including stress, anxiety, depression, nutrition, and social support, affect the pregnant women as well as their offspring in utero. There is a ‘third pathway’ for the familial inheritance of risk for psychiatric illness beyond shared genes and the quality of parental care: the impact of pregnant women’s distress on fetal and infant brain–behavior development.
Our projects involve fetal assessment, newborn neuroimaging, genetics, epigenetics, psychoneuroimmunology, parent–child interaction, supportive interventions, and health services research to:
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characterize maternal experiences, the effects on children’s development, and the biological pathways mediating these effects
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promote maternal psychobiological health for the parent–child dyad
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identify effective perinatal mental health treatment models.
Our Conceptual Framework
- psychology and biology as different levels of analysis and have mutual, bi–directional influences
- development as a construction that reflects a succession of adaptations that evolve over time with change constrained by prior adaptation yet possible at many points, including during adulthood (Sroufe, 1997)
Our Approach
Our research is informed by the developmental origins of health and disease (DOHaD) model. In David Barker’s words, ‘the womb is an influential first home.’
Based on animal models as well as epidemiological and observational studies, findings indicate that experience-based changes in the biology of pregnant women are associated with variations in cardiovascular, metabolic, as well as neurobehavioral development in children and adults.
We Aim To
- detect variation in fetal development associated with maternal experiences and determine the relevance of these fetal characteristics to children’s future functioning
- use MRI and EEG methodology to characterize differences in newborn brain development related to these prenatal exposures, and to determine the functional significance of these differences in terms of infant behavior and as they may be modified by postnatal factors such as maternal caregiving sensitivity
- identify biological processes for the transmission of pregnant women's experience to the fetus based on the following methodology: ambulatory assessment of blood pressure, HPA axis, immune activity; methylation in cord blood and placenta
- determine if successful psychotherapeutic intervention with depressed and/or highly stressed pregnant women and individuals can improve women’s overall functioning and the neurobehavioral profile of the offspring, suggesting less risk of mental health disorders in the future.
Participate in a Study
We are recruiting for several research studies examining the experiences of pregnant women and what enables parents to feel less stressed during pregnancy and the postpartum period. If you are interested in participating and/or learning more about our studies, please contact Ms. Khadija Jones, Clinical Research Manager, PerinatalPathways Lab at: kj2660@cumc.columbia.edu
Current Grant-Funded Research Studies
Below is a list of ongoing studies conducted within the PerinatalPathways Laboratory at Columbia University Irving Medical Center, which has received continuous NIH funding since 2000. Archive of past studies also available.
Leveraging IVF to Identify Prenatal Effects Independent of Shared Maternal-Child Genes.
(1R01HD118949-01; Monk, C (PI))
To rigorously test the Developmental Origins of Health and Disease (DOHaD) research model, this project will leverage the spectacular scientific advancements of in vitro fertilization (IVF) and compare maternal prenatal distress effects between IVF donor oocyte/embryo and non-donor oocyte pregnancies. This will be the first study to use multidisciplinary (neurobehavioral, epigenetic, transcriptomic) methods with adoption-at-conception preg- nant individuals to determine whether prenatal programming can be detected independent of shared maternal- child genes.
Investments in mothers' and babies' health and well-being during pregnancy, perinatal and post-natal period: evidence from an unconditional cash allowance program in the Appalachian region, USA, 2024-2027.
(Monk, C (PI))
Economic hardship during pregnancy and the postpartum period is associated with poorer maternal and infant health outcomes in the United States. Direct cash support has emerged as a promising intervention to reduce financial strain, yet its impact on maternal and infant health remains understudied. In this project, we will examine whether providing unconditional cash assistance during pregnancy and early infancy improves infant growth and health outcomes, maternal physical and mental well-being, access to healthcare, and the ability to make healthier food choices. In partnership with The Bridge Project, this study aims to identify whether direct cash support can mitigate economic stress and improve health outcomes for mothers and infants experiencing socioeconomic disadvantage.
Stress phenotypes and preterm birth: immune and energetic cellular dysregulation and the preventive effect of social support
(5R01MD016278-04; Monk, C., Gyamfi-Bannerman, C., Picard, M., Trumpff, C. (MPI))
Pregnancy ends in preterm birth (PTB) for approximately 1 in 10 women, though more often for Non-Hispanic Black women, 14.12% PTB rate, compared to 9.09% for Non-Hispanic White women. Psychosocial stress and childhood trauma each are associated with risk for PTB and PTB has an intergenerational impact: mothers born preterm are more likely to give birth pretern, especially amongst Black women. In this project, we will study mitochondria, which contain their own genome, the mitochondria DNA, and are inherited from the mother, as they represent a potential intersection point between psychosocial experiences and their biological embedding in underlying disease outcomes such as PTB.
Bronx Demonstration Project
(Monk, C. (PI))
The transition to parenthood is a critical period marked by increased psychological stress and shaped by the quality of perinatal care. Persistent disparities in access to coordinated, patient-centered care contribute to adverse maternal and infant outcomes, including poor mental health and adverse birth outcomes. In this project, we will use non-interventional focus groups with obstetric patients and healthcare providers, conducted in English and Spanish, to identify gaps in perinatal care and inform strategies to strengthen communication, care coordination, and access to resources. In collaboration with the Bridge Directory and the Morris Heights Health Center Women’s Health Pavilion, this study aims to inform equitable perinatal care interventions with potential two-generation impact.
The Impact of the Auditory Environment in Preterm and Term Infants
(5K23DC020967-02 ; Hammond, J.(PI))
Preterm infants are at risk for impaired language development due to physiologic insults, white matter injury, and the atypical auditory environment of the Neonatal Intensive Care Unit. The purpose of the proposed work is to investigate the influence of the auditory environment on attention to and auditory recognition memory for maternal voice as well as auditory cortex development in premature infants and fetuses subsequently born at term while accounting for variables known to impact language development. The ultimate goal of this work is to apply these findings to the design and implementation of interventions in the Neonatal Intensive Care Unit, which promote experience-dependent plasticity and improve the long-term outcomes of premature infants.
Publications
For nearly 30 years, our researchers have generated evidence that advances our understanding of perinatal mental health, child development, and two-generation well-being. Our work is inter-disciplinary, spanning basic science, clinical intervention research, implementation studies, and systems-level change to enhance how healthcare professionals support new families and their children during the transition to parenthood. Below are a select few publications. Please refer to PubMed to find our complete list of publications.
Mental health service utilization in a novel insurance-based Ob/Gyn integrated model for women across the lifespan.
Lavallée A, Babineau V, D'Antonio K, Werner E, Drysdale AT, Osbourne M, Grubb M, Moise N, Reuveni I, Zhang Z, Lee S, Dumitriu D, D'Alton M, Monk C. Archives of Women's Mental Health. 2026 Jan 5;29(1):5. doi: 10.1007/s00737-025-01652-4.PMID: 41486212
Politics and development as drivers of women's reproductive mental health.
Monk C.World Psychiatry. 2025 Jun;24(2):216-217. doi: 10.1002/wps.21306.PMID: 40371779 Free PMC article. No abstract available.
Practical resources for effective postpartum parenting (PREPP): a randomized controlled trial of a novel parent-infant dyadic intervention to reduce symptoms of postpartum depression.
Grubb MD, Wilson CA, Zhang Z, Liu G, Lee S, Monk C, Werner EA.Am J Obstet Gynecol MFM. 2024 Dec;6(12):101526. doi: 10.1016/j.ajogmf.2024.101526. Epub 2024 Oct 18.PMID: 39426626
The transition to parenthood in obstetrics: enhancing prenatal care for 2-generation impact.
Monk C, Dimidjian S, Galinsky E, Gregory KD, Hoffman MC, Howell EA, Miller ES, Osborne C, Rogers CE, Saxbe DE, D'Alton ME.Am J Obstet Gynecol MFM. 2022 Sep;4(5):100678. doi: 10.1016/j.ajogmf.2022.100678. Epub 2022 Jun 18.PMID: 35728782 Free PMC article.
Added sugar intake during pregnancy: Fetal behavior, birth outcomes, and placental DNA methylation.
Trumpff C, Sturm G, Picard M, Foss S, Lee S, Feng T, Cardenas A, McCormack C, Champagne FA, Monk C.Dev Psychobiol. 2021 Jul;63(5):878-889. doi: 10.1002/dev.22088. Epub 2021 Jan 7.PMID: 33415750
Maternal prenatal stress phenotypes associate with fetal neurodevelopment and birth outcomes.
Walsh K, McCormack CA, Webster R, Pinto A, Lee S, Feng T, Krakovsky HS, O'Grady SM, Tycko B, Champagne FA, Werner EA, Liu G, Monk C.Proc Natl Acad Sci U S A. 2019 Nov 26;116(48):23996-24005. doi: 10.1073/pnas.1905890116. Epub 2019 Oct 14.PMID: 31611411 Free PMC article.