The monoamine and intracellular calcium systems are two major elements of nervous system functions. However, their role in human brain development is unclear. We studied the association between activity of monoamine and intracellular calcium systems during prenatal life and subsequent psychomotor performances in healthy children. We used prospective data from 247 children followed from birth through 6 y of age. Among those, 195 were examined at 9 mo using the Brunet-Lézine Scales, whereas 126 were examined at 3 y and 100 at 6 y using the McCarthy Scales of Children's Ability. A blood sample was collected from the umbilical cord to measure levels of dopamine and serotonin metabolites (homovanillic acid and 5-hydroxyindoleacetic acid, respectively) and ATPase activities (Na ϩ K ϩ -ATPase and Ca 2ϩ Mg 2ϩ -ATPase). The hand skill score at 6 y of age was significantly and negatively correlated with ATPase activities and with monoamine metabolite concentrations. No other cognitive score was related to biochemical measures at birth. Results were adjusted for child's sex, mother's educational level, duration of labor, and tea consumption. Composite scores of ATPase activities and monoamine metabolite concentrations measured at birth explained 29% of hand skill score variance at 6 y. Our results demonstrate the importance of prenatal factors on monoaminergic and ATPase activities in early human psychomotor development. This study also suggests that specific psychometric measures such as fine motor tests may be a better developmental measurement to correlate with biochemical factors than general cognitive scales. The monoamine system, which includes the major neurotransmitters dopamine and serotonin, is likely to play an important role in brain development (1). Secretion of monoamines begins early in development of the human embryo (2). The perinatal period is characterized by high levels of secretion and oxidation of monoamines, with a subsequent decrease during early childhood (3). Monoamines have a neurotrophic effect on differentiation and growth of neural tube cells (4).Insults occurring during the perinatal period, such as hypoxicischemic lesions, exposure to pharmaceutical substances, or infection, often lead to motor disturbances, which persist until school age (5). Severe asphyxia at birth is responsible for a reduction in dopamine neurons, and the intensity of this reduction is correlated with the degree of motor disturbance (6). The genetic syndromes that affect the metabolism of monoamines manifest themselves by motor disturbances starting at birth (7), and even an early therapeutic intervention that ensures normal cognitive development does not have a positive effect on manual dexterity (8). Upstream, metabolism of the monoamine system is regulated in part by the activity of MAO. Oxidation of dopamine is a known source of free radicals that are particularly harmful to membranes (9). A study showed that the activity of MAO is in part genetically predetermined and that its high activity can be associated, in no...