Psychological health

Children of Mothers Infected by COVID in Pregnancy

by brain and behavior staff

A preliminary study of thousands of children born during the pandemic found that those whose mothers tested positive for COVID-19 during pregnancy were more likely to develop a developmental disorder during the first 12 months of their lives.

A team led by Roy H. It accounted for 7,772 live births of 7,466 women, 222 of whom had a positive PCR test for COVID-19 during pregnancy.

The mothers were in their early 30s on average, and included women who identified as Hispanic (15 percent), Asian (10 percent), black (8.4 percent), and white (69 percent). In all, 6.3 percent, or 14 of the 222 offspring whose mothers had COVID-19 during pregnancy, had a diagnosis of a neurodevelopmental disorder by age 12 months. This compares with 3 percent, or 227 of the 7,550 babies born to mothers who did not receive a positive COVID test during pregnancy.

A wealth of data from epidemiological studies over the years has shown that maternal infection during pregnancy, including viral infection due to influenza, is associated with adverse neurodevelopmental outcomes in the offspring. The risks of a wide range of disorders (autism spectrum disorder, schizophrenia, cerebral palsy, cognitive impairment, bipolar disorder, anxiety, and depression) are believed to be elevated to varying degrees depending on a number of variables, including the severity of the infection and the potential for pathological health conditions of the mother.

While most of these disorders take years to become apparent in young adults, some — including various types of cognitive dysfunction — can be detected in the early years of life. While the 12-month period is usually too early to detect, for example, autism spectrum disorders, some believe initial developmental signs indicate an increased risk in a child. The developmental diagnoses that Dr. Perlis and his study colleagues reported were mostly disorders of motor function and speech.

The link between maternal infection during pregnancy and an increased risk of neurodevelopment in the child is thought to be attributable to inflammation caused by maternal infection. Fetal brain development may be affected by the mother’s immune response to infections that can travel across the placenta.

Dr. Perlis’ team notes that emerging evidence already indicates that COVID-19 infection may be linked to preterm labor and possibly other obstetric complications. All studies specifically related to COVID, including its own, should be considered preliminary, given that children born to infected mothers at the start of the epidemic are still only three years old. The data on the babies born in the study by Dr. Perlis and colleagues also cannot reveal anything about the different levels of risk likely to match a mother’s infection through one of the newest strains of COVID.

Among the results of the current study, it was clear that COVID infection during pregnancy was most likely to increase the child’s neurodevelopmental risk when infection occurred in the third trimester; and mothers with COVID infection were more likely to give birth prematurely (14.4% versus 8.7%).

Because all preterm babies, together, have a higher neurodevelopmental risk than babies born full term, it was important for the team to identify increased neurodevelopmental risks in children of affected mothers who were born on time. After accounting for preterm birth, the odds of a neurodevelopmental diagnosis were still 86 percent higher in babies of infected mothers, indicating that the relationship between MERS infection during pregnancy and the child’s neurodevelopmental risk is not just a reflection of more premature births.

Perlis’ team and commentator in the journal in which the study appeared, JAMA Network Open, noted that the results of this study were not designed to establish a causal relationship between maternal COVID infection and the risk of neurodevelopment in the child, only an association.

This is among the reasons why the team is calling for the research community to conduct larger, longer-term follow-up studies to investigate the impact of COVID infection during pregnancy on both mothers and their babies.

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