Covid during pregnancy may raise risk of neurodevelopmental disorders

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So much more is now understood about Covid compared to three years ago. However, scientists are still learning about the long-term effects of infection. Now a study has found it could have an impact on unborn children.

New research led by investigators at Massachusetts General Hospital (MGH), found that baby boys born to mothers with SARS‐CoV‐2 infection during pregnancy were more likely to receive a neurodevelopmental diagnosis in the first 12 months after delivery.

Neurodevelopmental disorders are mainly associated with the functioning of the neurological system and brain.

They can include disorders such as attention deficit hyperactivity disorder (ADHD), autism, learning disabilities, cerebral palsy, and impairments in vision and hearing.

It comes as previous studies have found associations between other infections during pregnancy and increased risk of neurodevelopmental disorders in children, such as autism spectrum disorder.

As part of the study, published in JAMA Network Open, scientists examined electronic health records for 18,355 live births during the COVID-19 pandemic, including 883 (4.8 percent) to individuals with SARS‐CoV‐2 positivity during pregnancy.

Of the 883 Covid–exposed children, 26 (three percent) received a neurodevelopmental diagnosis during the first 12 months of life.

Among the unexposed offspring, 317 (1.8 percent) received such a diagnosis.

Maternal SARS‐CoV‐2 positivity was associated with a nearly two-fold higher odds of a neurodevelopmental diagnosis at 12 months of age among male children, after accounting for factors such as race, ethnicity, medical insurance status, hospital type and maternal age.

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However, it was not linked with a higher risk in female children.

At 18 months, the effects were more modest in males, with maternal Covid positivity linked to a 42 percent higher odds of a neurodevelopmental diagnosis at this age.

Too few of the mothers were vaccinated to determine whether vaccination changed risk.

Co–lead author Andrea Edlow, an associate professor of Obstetrics, Gynecology, and Reproductive Biology, and a Maternal-Foetal Medicine specialist at MGH, said: “The neurodevelopmental risk associated with maternal SARS-CoV-2 infection was disproportionately high in male infants, consistent with the known increased vulnerability of males in the face of prenatal adverse exposures.”

Her colleague and co–lead author Roy Perlis, noted that larger studies and longer follow‐up will be required to reliably estimate or refute the risk observed.

“We hope to continue to expand this cohort, and to follow them over time, to provide better answers about any longer-term effects,” he said.

The study concluded that Covid during pregnancy had a similar effect to other viral infections when it comes to the health of the child.

“Overall, our results are consistent with abundant evidence that exposure to infection during pregnancy—including viral infections such as influenza—is associated with an increased risk for neurodevelopmental morbidity in offspring,” it said.

“Such risk was initially detected as an increase in schizophrenia and autism spectrum disorder diagnoses following influenza and rubella pandemics, was recapitulated in animal models, and was more recently directly tested in large registry studies.

“Because the neurodevelopmental risk in offspring is thought to be mediated in large part through maternal and placental immune activation and has been observed in other viral infections that, similar to SARS-CoV-2, are not thought to directly infect foetal brain tissue it is biologically plausible that SARS-CoV-2 infection in pregnancy could impact offspring risk for neurodevelopmental disorders.”

According to the NHS, contracting Covid in the late stages of pregnancy could cause your baby to be born prematurely or have a low birthweight.

“It can also increase the risk of having a stillbirth,” it adds.

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