Clinically relevant maternal symptoms may co-occur with pregnancy complications, nutritional deficits, or stress-reactive physiology, all of which can affect neurodevelopment.9 In addition, prenatal depression may alter DNA methylation in key stress-related genes (eg, NR3C1 [OMIM 600535], BDNF [OMIM 113505]), with lasting associations with brain development.9 Genetic predispositions to depression may be associated with differences in offspring’s brain connectivity.43,54. This evidence concerns the gene NR3C1 and depressive symptom measurement.