COVID during pregnancy associated with neurodevelopmental disorders in infants

Infants infected with COVID-19 in utero appeared to be at increased risk of neurodevelopmental disorders, especially if the infection occurred in the last semester, according to a cohort study.

Diagnosis of neurological development was twice as common (6.3% vs. 3.0%) in the first year of life after exposure during pregnancy, with Dr. Roy Perlis and colleagues at the Quantitative Health Center at Massachusetts General Hospital in Boston. Reported. JAMA network open..

This association continues to adjust for race, ethnicity, insurance status, offspring gender, maternal age, preterm birth (OR 1.86, 95% CI 1.03-3.36), and coronavirus exposure during the third trimester. The relationship with was most prominent (OR 2.34, 95% CI 1.23-4.44).

Previous studies have also shown a link between viral infections such as influenza during pregnancy and developmental problems such as autism, cognitive dysfunction, anxiety, and depression. Many of these problems are not seen until adolescence or adulthood, and “the magnitude of these effects and the strength of their associations vary, but the consistency of such associations is difficult to ignore,” Perlis said. Group says.

And, in particular, COVID-19 is associated with neuropsychiatric symptoms that can last up to 1 year after infection in both children and adults.

another Recent research It showed a delay in neural development at 6 months of age born during the pandemic, but was not affected by SARS-CoV-2 infection in the mother, suggesting a role from stress felt by the mother during pregnancy during the pandemic. There is.

But there were other potential explanations. For example, in a Perlis study, the difference between age at confirmation and universally symptomatic maternal infection, and the other one-third being asymptomatic, etc. editorial According to Torri Metz, MD of the University of Utah in Salt Lake City.

“Because it’s only two years after the pandemic occurred, many of the effects of intrauterine exposure to maternal SARS-CoV-2 infections are not yet fully understood,” she writes. Current studies) and alpha variants, “because they are the only children who have reached the age sufficient to undergo a rigorous neurodevelopmental assessment.”

However, the delta mutant “substantially damages the placenta and has a much higher risk of stillbirth than other mutants,” Mets said. “Importantly, previous vaccination has a protective effect on the adverse effects of SARS-CoV-2 on maternal offspring beyond the direct benefits of cord blood and infancy persistent antibodies. There is no data on whether to bring it. “

She also emphasized the importance of helping affected children. “Probably the most important issue is how to intervene to mitigate the negative effects of a pandemic on young children. People at highest risk are children of this generation born during the COVID-19 pandemic. As we follow our life course, it helps healthcare professionals allocate resources appropriately to improve results. “

The Perlis study was conducted using electronic health record (EHR) data from six regional hospitals and two academic medical centers to identify births that occur between March and September 2020. I did.

Of the 7,772 new mothers who participated in the study, 222 (2.9%) were positive by PCR for SARS-CoV-2 at any time during pregnancy. Of the exposed offspring, 14 had a neurodevelopmental diagnosis in the first year of life, while 227 out of 7,550 offspring were not exposed.

The types of neurodevelopmental disorders that occurred were similar among the groups, most commonly affecting speech and motor function. However, exposed offspring tended to be diagnosed early (median 214 days vs. 275 days).

Preterm birth was also common in children exposed to the virus in utero (14.4% vs. 8.7%). P= 0.003), “Adjustment of preterm birth did not explain all of the observed increased risk of receiving a neurodevelopmental diagnosis,” the authors said.

Researchers have not been able to identify a causal relationship in their study, and as children born during the first wave of the pandemic grow up, many common disorders do not appear until late childhood or late life. Therefore, I admitted that I need to do more research. Longer and larger investigations are also required to determine the exact mechanism in operation.