Epigenetic foundations of providing support to children left without parental care

Context and relevance. This article presents a review of studies in the field of epigenetics that describe external factors capable of altering the epigenetic landscape of a child’s genome and adversely affecting their subsequent development. These factors include traumatic historical events (the Dutch “Hunger Winter” and the Quebec “Ice Storm”), parental smoking, maternal nutritional patterns during pregnancy, and maternal relinquishment of the child. Objective. To identify epigenetic foundations for providing support to children deprived of parental care. Hypothesis. Effective prevention of social orphanhood and assistance to children with developmental impairments require consideration of environmental influences on the child’s genomic epigenetic status. Methods and materials. The study was conducted as a desk-based (literature-based) review employing thematic synthesis across the following domains: prenatal factors, postnatal conditions, molecular epigenetic mechanisms, long-term consequences, and recommendations for support — with a specific focus on children deprived of parental care, both in institutional settings and foster families. Results. Prevention of adverse epigenetic modifications should begin with support for the pregnant mother, as the most profound gene-regulatory alterations affecting the child’s health occur during the prenatal period. Exposure to adverse and unsafe postnatal environments disrupts the child’s stress-response mechanisms, which may subsequently manifest during adolescence as “dysregulated” behavior and lead to foster family disruption (i.e., the foster family’s decision to discontinue care). Conclusions. Support for pregnant mothers is essential, given that the most severe epigenetic alterations influencing child health originate in utero. To prevent and mitigate disruptions in stress-response mechanisms among adolescents, foster parents should receive specialized training during the pubertal period. Adolescents themselves should be offered behavioral therapy aimed at partially compensating for impaired biological stress-response pathways through the acquisition of specific behavioral patterns that facilitate coping with stressful situations. An additional support mechanism for both the child and the foster family involves professional crisis or emergency intervention during periods of acute behavioral deterioration in adolescence, when the foster family is unable to manage the child’s needs.