Orbitofrontal cortex functional connectivity mediates the relationship between fetal growth and childhood impulsivity

Abstract Exposure to adversity during the prenatal period may provoke developmental alterations and result in health outcomes later in life. The orbitofrontal cortex (OFC), a key region for reward-based decision-making and impulsive behavior, is particularly sensitive to adversity. However, it’s unclear whether altered OFC functional connectivity links poor fetal growth to later behavioral outcomes. Here we show that left OFC and right precentral gyrus functional connectivity mediates the association between being born small for gestational age (SGA) and poor performance in a decision-making assessment. Specifically, SGA is associated with reduced connectivity, while increased connectivity is associated with better decision-making performance. These findings highlight the importance of the prenatal period for healthy development and suggest that OFC-related neurofunctional alterations may represent early markers of vulnerability to later psychopathology and maladaptive behavior, and target individuals for proper intervention.