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The goal of this meeting was to discuss study design and related issues (e.g., sampling strategy, recruitment and retention of high risk populations, bioethical and social service implications) for a longitudinal study of the impact of pre- and postnatal substance exposure (including opioids, opioid treatment medications, cannabis, alcohol, tobacco, other prescription or illicit substances, alone or in combination) on brain development, mental illness, substance use, and social/behavioral/academic achievement. It is envisioned that successful execution of a program of this breadth and depth will require a broad interdisciplinary team of investigators with collective expertise in pregnancy, neonatal, and early childhood affective, cognitive, and social development; longitudinal cohort studies; developmental neuroimaging; and social/legal and environmental issues.