The Fetal Behavior Studies Program is a clinical research program that examines fetal and infant neurobehavioral development to assess neurological integrity and behavioral stability. Fetal neurobehavior is measured by recording fetal heart rate, motor activity, behavioral state, and responsiveness to extrauterine stimuli using a protocol and coding system we developed called the Fetal Neurobehavior Coding System (FENS).

Biography

I was originally trained as a nurse and hold board-certification as a clinical nurse specialist in child and family psychiatry. I obtained my BA in Neuroscience from Clark University and earned my doctorate at the University of Connecticut in Biobehavioral Sciences/Developmental Psychobiology. I completed my postdoctoral research fellowship in the Department of Psychiatry and Human Behavior at Brown Medical School. My current research and clinical interests include neurobehavioral development, fetal and infant development, sleep development and disorders, perinatal and infant mental health, prenatal exposures, autism, and child psychopathology. I am currently conducting research on fetal and infant neurobehavioral development in relation to maternal depression and antidepressant treatment during pregnancy.

Research Description

The long term goal of my research program is examine potential mechanisms for the development of psychopathology in children in order to prevent such disorders, find better diagnostic tools and create better treatment options. My work includes consideration of variables that contribute to resilience in those children that do not develop a psychiatric diagnosis. This approach requires measurement of multiple systems of the developing child, including parental psychopathology and behavior, the infant-parent system, physiology, genetics, behavior, social communication, and the environment. The scope of my research program fosters collaboration with many other investigators at Brown University and other institutions.
My current research focuses on prenatal and postnatal neurobehavioral development of the fetus and fetal-maternal system in women who are depressed or using antidepressant medication. The goal of the study is to evaluate fetal neurobehavior during exposure to maternal Major Depressive Disorder (MDD) or SSRI medication use. Currently, we do not fully understand the risks and/or benefits to the mother and her fetus from SSRI medications. We also do not know if not treating MDD is a greater risk to the mother and fetus than SSRI medications. The data from the proposed study will give health care providers and their patients more information to draw upon when making treatment decisions during pregnancy. Other applications of these data include examining the effect of SSRI medications on developing serotonin systems and how this may alter long-term behavioral and emotional outcomes.
Measurement of fetal neurobehavior is accomplished by monitoring and recording fetal heart rate, motor activity, behavioral state, and responsiveness to extra-uterine stimuli using a protocol and coding system we developed called the Fetal Neurobehavior Coding System (FENS). The FENS was patterned after the NICU Network Neurobehavioral Scale (NNNS) developed by Dr. Barry Lester for at-risk infants. The two methods are used across development for a cohesive assessment of neurobehavioral development.
We are currently using the FENS to study the effects of fetal exposure to antidepressant medications, maternal depression, and maternal smoking, as well as buprenorphine and methadone treatment of heroine addiction.

Awards

2003 NASPOG Young Investigator Award. The North American Society For Psychosocial Obstetrics and Gynecology for the paper entitled: "Fetal behavioral reactivity and depressed maternal mood".

2001 First Place Research Award for Post-Doctoral Fellows
Brown Medical School Department of Psychiatry and Human Behavior, 2001
Salisbury, A., Bocanegra, M., LaGasse, L., Lester, B. Ultrasound Evaluation of Fetal Behavior In Mothers with Depressed Mood.

Affiliations

International Society for Developmental Psychobiology
International Society for Infant Studies
Marcé Society
North American Society For Psychosocial Obstetrics and Gynecology (NASPOG)
Sleep Research Society
Society for Research in Child Development
New York Academy of Sciences

Funded Research

ACTIVE

2/1/08 - 1/31/13 R01 MH078033 Principal Investigator
Fetal and Neonatal Neurobehavior and Prenatal Antidepressant Exposure
NIMH

9/1/11-8/31/16 R01 DA031188-01 Co-Investigator
MATERNAL SMOKING: HPA AND EPIGENETIC PATHWAYS TO
INFANT NEUROBEHAVIORAL DEFICITS
NIDA

9/1/07 - 6/30/12 R01 MH079153 Co-Investigator (PI: L.Stroud) Maternal depression, placental HPA regulation, & fetal-neonatal
stress response
NIMH

9/30/04 - 12/30/11 R01 DA015778 Co-Investigator (B. Lester, PI)
Maternal Opioid Treatment: Human Experimental Research
NIDA

7/1/05 - 11/30/11 R01 DA 019558 Co-Investigator (PI: L. Stroud) Prenatal Smoking, fetal behavior, and infant withdrawal
NIDA

COMPLETED

6/1/02 - 8/31/07 K23 MH065479-01 Principal Investigator
Maternal Antidepressant Use and Fetal Neurobehavior
NIMH

7/28/10 - 7/27/11 S10 RR026421 Principal Investigator
2D-4D Capable Ultrasound Machine
NIH National Center for Research Resources

7/01/07 - 6/30/10 R03 MH082214 Co-Investigator (PI: S. Sheinkopf)
Pre- and Postnatal Neurobehavioral Profiles in Infants at Risk for
Autism
NIMH

7/1/07 - 12/30/10 Clinical Innovator Award Co-Investigator (PI: L. Stroud)
Maternal Smoking: Fetuses in Withdrawal?
Flight Attendant Medical Research Institute

8/13/07 - 6/30/11 R34 MH079108 Co-Investigator (PI: C. Battle)
Treatment Decision-Making among Depressed Pregnant Women
NIMH

Selected Publications

• Lester BM, Miller RJ, Hawes K, et al. Infant neurobehavioral development. Seminars in perinatology. Feb 2011;35(1):8-19.(2011)
• Coyle MG, Salisbury AL, Lester BM, et al. Neonatal Neurobehavior Effects following Buprenorphine versus Methadone Exposure. Addiction. 2011;in press.(2011)
• Salisbury AL, Coyle MG, O'Grady KE, et al. Fetal Assessment before and after dosing with Buprenorphine or Methadone. Addiction. 2011;in press.(2011)
• Salisbury, A.L., High, P., Twomey, J., Dickstein, S., Chapman, H. and Lester, B.M., A Randomized Control Trial to Evaluate a Family Based Biopsychosocial Intervention for the Treatment of Infant Colic, Infant Mental Health Journal, 2011 In press(2011)
• Grant-Buettler M, Glynn LM, Salisbury AL, Davis EP, Sandman CA. Development of Fetal Movement between 26 and 36 Weeks' Gestation in Response to Vibro-acoustic Stimulation. Frontiers in Developmental Psychology. 2011;in press.(2011)
• McFarland J, Salisbury AL, Battle CL, Hawes K, Halloran K, Lester BM. Major depressive disorder during pregnancy and emotional attachment to the fetus. Archives of Women's Mental Health. Oct 2011;14(5):425-434.(2011)
• Ponder KL, Salisbury A, McGonnigal B, Laliberte A, Lester B, Padbury JF. Maternal depression and anxiety are associated with altered gene expression in the human placenta without modification by antidepressant use: Implications for fetal programming. Developmental Psychobiology. Nov 2011;53(7):711-723.(2011)
• Salisbury AL, Wisner KL, Pearlstein T, Battle CL, Stroud L, Lester BM. Newborn neurobehavioral patterns are differentially related to prenatal maternal major depressive disorder and serotonin reuptake inhibitor treatment. Depression and Anxiety. Sep 2 2011.(2011)
• Matook SA, Sullivan MC, Salisbury A, Miller RJ, Lester BM. Variations of NICU sound by location and time of day. Neonatal network : NN. Mar-Apr 1 2010;29(2):87-95.(2010)
• Salisbury AL. Before Infant Assessment: Fetal neurobehavior. In: Lester BM, Sparrow JD, eds. Nurturing Children and Families: Building on the Legacy of T. Berry Brazelton West Sussex, UK: John Wiley and Sons; 2010:29-39.(2010)
• Pearlstein T, Howard M, Salisbury A, Zlotnick C. Postpartum depression. American Journal of Obstetrics and Gynecology, 2009(4): 357-64. PMID:19318144(2009)
• Salisbury AL, Ponder KL, Padbury JF, Lester BM. Fetal effects of psychoactive drugs. Clin Perinatol. Sep 2009;36(3):595-619.(2009)
• Stroud LR, Paster RL, Papandonatos GD, et al. Maternal smoking during pregnancy and newborn neurobehavior: effects at 10 to 27 days. The Journal of Pediatrics. Jan 2009;154(1):10-16.(2009)
• Battle CL, Zlotnick C, Pearlstein T, et al. Depression and breastfeeding: which postpartum patients take antidepressant medications? Depress Anxiety. 2008;25(10):888-891.(2008)
• Salisbury AL, Lester BM, Seifer R, et al. Prenatal cocaine use and maternal depression: effects on infant neurobehavior. Neurotoxicology and Teratology. May-Jun 2007;29(3):331-340.(2007)
• Salisbury AL, Fallone MD, Lester B. Neurobehavioral assessment from fetus to infant: the NICU Network Neurobehavioral Scale and the Fetal Neurobehavior Coding Scale. Mental Retardation and Developmental Disabilities Research Reviews. 2005;11(1):14-20.(2005)
• Salisbury AL, Yanni P, Lagasse LL, Lester B, eds. Maternal-Fetal Psychobiology: A Very Early Look at Emotional Development. Oxford, UK: Oxford University Press; 2004. Nadel J, Muir DW, eds. Emotional Development: Recent Research Advances.(2004)
• Salisbury A, Law K, LaGasse L, Lester B. MSJAMA. Maternal-fetal attachment. Jama. Apr 2 2003;289(13):1701.(2003)
• Salisbury AL, Minard K, Hunsley M, Thoman E. Audio Recording of Infant Crying: Comparison with Maternal Cry Logs. International Journal of Behavioral Development. 2001;25(5):458-465.(2001)