Psycho-Neuro-Endocrine-Immunology, DOHaD and Mindfulness: Towards an Integrated Model of Prenatal Salutogenesis

Abstract

Over the past thirty years, the DOHaD (Developmental Origins of Health and Disease) paradigm has radically transformed our understanding of the aetiology of chronic diseases, shifting the focus from genetic determinism to the biological plasticity of early life. This perspective converges naturally with Psycho-Neuro-Endocrine-Immunology (PNEI), which interprets the organism not as a collection of isolated systems but as an interconnected network in which the nervous, endocrine, immune and metabolic systems engage in constant dialogue with the psychosocial environment. The intersection of these two approaches reveals pregnancy as the temporal window of maximum susceptibility and evolutionary opportunity. Within this scenario, the placenta emerges as a sophisticated interface organ, capable of translating maternal environmental stimuli — including stress signals and adaptive responses — into molecular signals that shape the neurodevelopment, hypothalamic-pituitary-adrenal (HPA) axis and metabolic setting of the offspring. In this research landscape, mindfulness-based practices are emerging as promising non-pharmacological and transdiagnostic interventions. Although scientific evidence has already validated their efficacy in regulating the stress response, autonomic nervous system balance and low-grade chronic inflammation, the hypothesis that such modulation may directly influence fetal programming remains an unexplored frontier of considerable clinical potential. The present review aims to bridge this gap by offering a critical synthesis that integrates contemplative neuroscience, polyvagal theory, epigenetics and perinatal medicine. Through the proposal of an original theoretical model, it explores how maternal neurovegetative regulation — analysed in terms of heart rate variability (HRV) and placental communication — may act as a systemic determinant of health. From this perspective, mindfulness is redefined not merely as a tool for distress reduction, but as an active modulator of salutogenic processes, capable of fostering, from the earliest stages of development, the biological foundations of human resilience.