COVID-19 News: Harvard Study Finds That Babies Born To Mothers Exposed To SARS-CoV-2 Likely To Develop Neurodevelopmental Disorders!

COVID-19 News: During the first year of the COVID-19 pandemic, we had lots of so called medical ‘experts’ and health authorities who made claims publicly that the SARS-CoV-2 coronavirus does not affect unborn babies or even infants and that it was of no threat to pregnant mothers.


Pic Credit: Bill O’Leary/Washington Post via Getty Images

Past forward, three years later and we are now discovering whole array of medical and health issues arising in this subgroup of the general population.
 
A new study by researchers from Massachusetts General Hospital and Harvard Medical School, Harvard T. H. Chan School of Public Health with scientists from the University of South Florida College of Medicine have found that babies born to mothers exposed to SARS-CoV-2 are likely to develop neurodevelopmental disorders especially male offspring. Such babies will ultimately develop behavioral disorders, autism, schizophrenia or other mental issues!
 
Past studies using large registries have suggested a modest increase in risk for neurodevelopmental diagnoses among children of mothers with immune activation during pregnancy, and such risk may be sex-specific.
https://pubmed.ncbi.nlm.nih.gov/3337616/
 
https://pubmed.ncbi.nlm.nih.gov/2393346/
 
The study team aimed to determine whether in utero exposure to SARS-CoV-2 is associated with sex-specific risk for neurodevelopmental disorders up to 18 months after birth, compared with unexposed offspring born during or prior to the COVID-19 pandemic period.
 
This retrospective cohort study included the live offspring of all mothers who delivered between January 1 and December 31, 2018 (born and followed up before the COVID-19 pandemic), between March 1 and December 31, 2019 (born before and followed up during the COVID-19 pandemic), and between March 1, 2020, and May 31, 2021 (born and followed up during the COVID-19 pandemic). Offspring were born at any of 8 hospitals across 2 health systems in Massachusetts.
Polymerase chain reaction evidence of maternal SARS-CoV-2 infection during pregnancy was used for the study.
 
For the study, electronic health record documentation of International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnostic codes corresponding to neurodevelopmental disorders were used.
 
The SARS-CoV-2 pandemic cohort included 18 355 live births (9399 boys [51.2%]), including 883 (4.8%) with maternal SARS-CoV-2 positivity during pregnancy. The cohort included 1809 Asian individuals (9.9%), 1635 Black individuals (8.9%), 12 718 White individuals (69.3%), and 1714 individuals (9.3%) who were of other race (American Indian or Alaska Native, Native Hawaiian or other Pacific Islander, more than 1 race); 2617 individuals (14.3%) were of Hispanic ethnicity. Mean maternal age was 33.0 (IQR, 30.0-36.0) years.
 
In adjusted regression models accounting for race, ethnicity, insurance status, hospital type (academic center vs community), maternal age, and preterm status, maternal SARS-CoV-2 positivity was associated wi th a statistically significant elevation in risk for neurodevelopmental diagnoses at 12 months among male offspring (adjusted OR, 1.94 [95% CI 1.12-3.17]; P = .01) but not female offspring (adjusted OR, 0.89 [95% CI, 0.39-1.76]; P = .77).
 
Similar effects were identified using matched analyses in lieu of regression. At 18 months, more modest effects were observed in male offspring (adjusted OR, 1.42 [95% CI, 0.92-2.11]; P = .10).
 
The study findings showed that offspring with SARS-CoV-2 exposure in utero had a greater magnitude of risk for neurodevelopmental diagnoses especially among male offspring at 12 months following birth. As with prior studies of maternal infection, substantially larger cohorts and longer follow-up will be required to reliably estimate or refute risk.
 
The study findings were published in the peer reviewed journal: JAMA network Open.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802745
 
The study findings clearly shows that male newborns (but not females) born to mothers infected with SARS-CoV-2 during pregnancy are more likely to receive a neurodevelopmental diagnosis within the first year of birth.
 
Co–lead author, Dr Andrea Edlow, MD MSc, an associate professor of Obstetrics, Gynecology, and Reproductive Biology, and a Maternal-Fetal Medicine specialist at Massachusetts General Hospital told COVID-19 News reporters at TMN, “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.”
 
In this study of 18,355 infants born during the COVID-19 pandemic, with 12 months of follow-up data, the study team found a significant increase in risk for male, but not female offspring. This was determined using two complementary approaches to address potential confounding factors. The effects were not due to preterm delivery, which was more prevalent among SARS-CoV-2-exposed offspring. Restricting the cohort to offspring with 12-month follow-up visits within the hospital system showed similar results, suggesting they are less likely a consequence of differential follow-up among exposed offspring. 
 
Since all deliveries occurred during the COVID-19 pandemic period, these effects cannot be primarily attributed to nonspecific pandemic-era stress, as both SARS-CoV-2-positive and uninfected mothers were exposed to such stress. Further research is needed to understand the mechanism by which maternal infection relates to sex-specific risk, but previous work has noted a differential impact of maternal infection and immune activation on male versus female immune and inflammatory signaling.
 
The study findings align with substantial evidence that the developing male brain is more vulnerable to in utero environmental effects, including maternal immune activation.
 
In general, the findings are in line with a wealth of evidence that exposure to infection during pregnancy, including viral infections like influenza, is linked to an increased risk for neurodevelopmental issues in offspring. This risk was initially detected as an increase in schizophrenia and autism spectrum disorder diagnoses following influenza and rubella pandemics and has been observed in animal models and large registry studies. The risk of behavioral dysfunction in offspring after maternal prenatal exposures has also been reported to be greater in male offspring in rodent models.
 
As the neurodevelopmental risk in offspring is thought to be mediated primarily through maternal and placental immune activation and has been observed in other viral infections that, like SARS-CoV-2, are not believed to directly infect fetal brain tissue, it is biologically plausible that SARS-CoV-2 infection during pregnancy could impact offspring risk for neurodevelopmental disorders.
 
Co–lead author Dr Roy Perlis, MD MSc, associate chief of Research in the Department of Psychiatry and director of the Center for Quantitative Health at Massachusetts General Hospital, notes that larger studies and longer follow-ups will be required to reliably estimate or refute the risk observed. He said, “We hope to continue to expand this cohort, and to follow them over time, to provide better answers about any longer-term effects.”
 
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