Exposure to COVID is associated with neurodevelopmental disorders

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Infants exposed to SARS-CoV-2 in the womb New research suggests an increased risk of developing neurodevelopmental disorders in the first year of life.

But whether exposure to the epidemic or a mother’s exposure to the same virus that may harm neurodevelopment in early childhood is unclear, caution investigators led by Roy Perlis, MD, MSc at Massachusetts General Hospital, Boston.

“In this analysis of 222 offspring of mothers infected with SARS-CoV-2, compared to the offspring of 7,550 mothers in the control (uninfected) group who gave birth during the same period, we observed that neurodevelopmental diagnoses are more common among exposed offspring, especially those exposed. for maternal infection in the third trimester of pregnancy”.

The study was published online June 9 in JAMA Network is open.

Speech and language disorders

The study included 7,772 predominantly single live births across six hospitals in Massachusetts between March and September 2020, including 222 (2.9%) births to mothers with confirmed SARS-CoV-2 infection by PCR during pregnancy.

In all, 14 of 222 children born to mothers with SARS-CoV-2 (6.3%) were diagnosed with a neurodevelopmental disorder in the first year of life versus 227 of 7,550 unexposed sons (3%) (unadjusted odds ratio) [OR], 2.17; 95% CI, 1.24 – 3.79; s = .006).

In the adjusted models for preterm birth, as well as race, ethnicity, insurance status, child sex, and maternal age, offspring exposed to COVID were significantly more likely to receive a neurodevelopmental diagnosis in the first year of life (odds rate, 1.86; 95% CI, 1.03–3.36; s = .04).

The magnitude of association with neurodevelopmental disorders was greater with SARS-CoV-2 infection in the third trimester (OR, 2.34; 95% CI, 1.23 – 4.44; s = .01).

The majority of these diagnoses reflect developmental disorders of motor function or speech and language.

The authors note that the finding of an association between prenatal exposure to SARS-CoV-2 and neurodevelopmental diagnoses at 12 months of age is consistent with the “large body of literature” linking maternal viral infection and maternal immune activation to neurodevelopmental disorders later in life.

However, they cautioned that there was no definitive link between prenatal exposure to SARS-CoV-2 and harmful neurodevelopment in the offspring, in part because children born to infected women in the first wave of the epidemic did not make it to the second. Birthday – The time when a neurodevelopmental disorder such as autism is diagnosed.

There is also a risk of ascertainment bias arising from increased concern for the offspring of affected mothers who were exposed to the disease during pregnancy. The researchers note that these parents may be more inclined to seek evaluation, and clinicians may be more inclined to make a diagnosis or refer for evaluation.

However, as I mentioned before Medscape Medical NewsThe study findings support the findings of research released at the European Psychiatric Association (EPA) 2022 conference; These results also demonstrated an association between maternal SARS-CoV-2 infection and impaired neurodevelopment in 6-week-old infants.

Hypothesis generation

In an accompanying comment, Torri D. Metz, MD, MS, of the University of Utah Health, Salt Lake City, said Perlis and colleagues’ preliminary findings are “very important, yet many questions remain.”

“Basically everything we know now about the effects of in the womb The maternal exposure to SARS-CoV-2 infection is from children exposed to the early and alpha variants of SARS-CoV-2, because these are the only children who are now old enough to undergo a rigorous neurological evaluation,” Metz notes.

In the end, Metz says it’s no surprise that the pandemic and in the womb Maternal exposure to SARS-CoV-2 infection may adversely affect neurodevelopmental outcomes in young children.

However, as a retrospective cohort study, the study can only prove associations, not causation.

Metz writes, “This type of work is intended to generate hypotheses, and this goal was achieved because these preliminary findings generate many additional research questions to explore.”

Among them: Are there genetic predispositions to negative outcomes? Will we observe differential effects by SARS-CoV-2 variant, infection severity, and by last third of infection? Is it the virus itself or all the societal changes that occurred during this period, including differences in how those changes occurred between those with and without SARS-CoV-2?

“Perhaps the most important question is how do we intervene to help mitigate the negative effects of the pandemic on young children,” Metz notes.

“Future studies to validate these findings, elicit some of the nuances, and identify those most at risk will help healthcare practitioners appropriately allocate resources to improve outcomes as we follow the life path of this generation of children born during the COVID-19 pandemic,” she adds.

The study was supported by the National Institute of Mental Health and the National Institute of Child Health and Human Development. Perlis is an associate editor of JAMA Network Open but was not involved in the editorial review or resolution of this manuscript. Metz reported that it received fees and personal grants from Pfizer and grants from GestVision.

Gamma neto is open. Published online June 9, 2022. Full text, editorial

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