Babies whose mothers were infected with the coronavirus during pregnancy may face a higher risk of brain development disorders such as autism and bipolar disorder, according to a new study that looked at more than 7,500 births.
The finding, published Thursday in the journal JAMA Network Open, adds urgency to bringing coronavirus transmission under control, even though the new variants are less likely to cause severe cases of COVID-19.
Other viruses, such as influenza and measles, are thought to make babies more vulnerable to conditions such as autism, schizophrenia and depression if exposed in utero. Researchers from Massachusetts General Hospital and Harvard Medical School wondered if the same was true for SARS-CoV-2, the coronavirus that causes COVID-19.
“More than a decade of studies suggest that viral infection during pregnancy could be associated with neurodevelopmental disorders, so there was cause for concern about this virus as well,” said Dr Roy Perlis, director of the Massachusetts Center for Quantitative Health. General Hospital and lead author of the study.
The researchers looked at electronic health record data from deliveries that took place at eight Massachusetts medical centers during the early months of the pandemic, between March and September 2020. The records tracked babies’ development for a year after birth, looking for specific codes. this would indicate a diagnosis of a developmental disorder related to motor function, speech or language, among others.
Researchers found that of 7,550 babies whose mothers were infection-free during pregnancy, 3% had been diagnosed with impaired brain development before their first birthday. Of the 222 babies who were exposed to SARS-CoV-2 in utero, 6.3% were diagnosed by the time they turned 1 year old.
After the researchers took into account other factors that may affect a child’s risk of a neurodevelopmental problem – such as premature birth, the mother’s age and the baby’s gender – they decided calculated that babies exposed prenatally to SARS-CoV-2 were 86% more likely to be diagnosed in their first year compared to babies who were not exposed before birth.
Perlis stressed that the overall risk of developing these disorders remains low for all babies.
He added that one year is not enough time to fully understand how prenatal exposure to the coronavirus affects children. Still, he said, he was surprised to find a connection in the first place.
“Frankly, I would have been a lot happier if we hadn’t seen anything at all,” he said.
In a commentary that accompanies the study, Dr Torri Metz suggested that the coronavirus may not be directly responsible for the developmental problems in babies.
“We wonder if it is the virus itself or the societal changes and stresses of the pandemic that are negatively affecting childhood outcomes,” wrote Metz, a maternal-fetal medicine specialist at the University of Utah Health.
But Dr Kristina Adams Waldorf, an obstetrician-gynecologist who studies infectious diseases in pregnancy at the University of Washington Medicine, said the findings were similar to research on infections caused by other viruses.
“We know from previous studies, including one involving millions of pregnancies in Sweden, that exposure to different types of infections such as influenza during pregnancy can impact the neurological development of the child,” said Adams Waldorf, who was not involved in the new study.
With the coronavirus, more research will be needed to see if the severity of a mother’s infection matters.
“Unfortunately, it is very possible that asymptomatic or mild infections are also linked to neurodevelopmental disorders in children,” she said.
Either way, the medical advice for pregnant women remains unchanged.
“This should be another wake-up call for pregnant women to get vaccinated, get a reminder, stay in mask and take as many precautions as possible,” Adams Waldorf said.
Sumeet Kulkarni, Los Angeles Times
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