Transdisciplinary fetal-neonatal neurology training integrates women’s and children’s health with life-course brain capital strategies: a narrative review

Neurological and mental health disorders affect over one-third of the global population. Healthcare systems continue to treat maternal brain health and neurodevelopment as separate domains. Critical intervention windows continue to be missed before and during the first 1,000 days after conception. Current fetal-neonatal neurology training reflects healthcare fragmentation. Specialty-siloed education impedes integrative critical thinking that more successfully capitalizes on pre-conception and gestational neuroprotective opportunities. This narrative review presents perspectives that argue for a transdisciplinary approach among stakeholders that advances life-course brain healthcare. Integrative women's and children's health, the developmental origins of health and disease, cultural neuroscience, and brain health capital frameworks collectively contribute to an educational, practice and research model. This methodology more productively addresses public health priorities to offer equitable global brain health care based on knowledge of intersectionality. We propose that every pregnancy represents a brain health intervention opportunity. Healthcare bundles have been defined as a set of three to five evidence-based interventions to assess the quality and outcome of medical care choices. Equity-informed brain care bundles similarly can be developed to assess proactive and reactive neuroprotective intervention outcomes. Gene-environment interactions will influence the dynamic neural exposome across each person's lifespan. More effective therapeutic options can shift intergenerational neurodevelopmental trajectories to improve neurologic and mental health for entire communities. Combining biological, social, and structural determinants determine the direction of vulnerability or resilience pathways based on time-sensitive shared healthcare decisions. Two clinical vignettes ground this theoretical framework with fetal-neonatal neurology practice experiences. Emphasis on fragmented care, limited genomic screening, structural inequity, and uncorrected environmental exposures diminish preventable neurological and maternal outcomes across generations. We propose five implementation recommendations: dismantle structural barriers to integrate care; redesign training around transdisciplinary competency frameworks; realign payment structures to incentivize coordinated care; reorient research priorities with integrated care models; and develop measurable metrics of integrated maternal-child brain health. Artificial intelligence-assisted monitoring and learning health system platforms offer infrastructural elements to enable equitable intervention scaling across diverse clinical settings. Implementation of this framework across each lifespan will reduce intergenerational burdens of neurological and mental health disorders to sustain global brain health equity.