Pregnancy

Pandemic-induced distress during pregnancy alters fetal brain development

Data from Lu YC, et al.  Common Med (London).  2022;doi:10.1038/s43856-022-00111-w.

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Compared to infants born before the COVID-19 pandemic, those born during the pandemic had decreased fetal brain development, which the researchers found was linked to higher levels of distress in women giving birth during the pandemic. .

“Understanding how contemporary stressors may influence fetal brain development during pregnancy has major implications for basic science and for informing public policy initiatives,” study lead author Catherine Limperopoulos, PhD, the head and director of the Developing Brain Institute at Children’s National Hospital and professor of pediatrics and radiology at George Washington University in Washington, DC, said in a press release. “Through this work, we are able to show that there is a problem, that it occurs before birth, and we can use this model to start exploring how we can reduce stress in mothers and support unborn babies.”

Data from Lu YC, et al. Common Med (London). 2022;doi:10.1038/s43856-022-00111-w.

Registration for studies

Limperopoulos and colleagues compared levels of maternal distress in 137 pregnant women enrolled between March 2014 and February 2020 and 65 pregnant women with no exposure to COVID-19 enrolled between June 2020 and April 2021. They also compared fetal brain volume and cortical folding using fetal MRI 182 and 92 scans available for the pre-pandemic and pandemic cohorts, respectively.

At the presentation for fetal MRI, the researchers administered four questionnaires to assess maternal distress – specifically looking at state anxiety, trait anxiety, stress and depression. Their analysis included measurements from 173 women who provided responses.

Maternal distress

Of the pregnant women who responded to the questionnaires, 34 (27.6%) in the pre-pandemic cohort and 26 (52%) in the pandemic cohort had high distress indicated in at least one of the questionnaires. Women in the pandemic cohort also had significantly higher levels of depression (beta coefficient = 1.7; 95% CI, 0.5-2.9) and stress (beta coefficient = 3.92; 95% CI). %, 2.03-5.81) compared to those of the pre-pandemic cohort. cohort.

MRI results

MRI scans revealed that the pandemic cohort had smaller fetal white matter volumes (least squares mean, 93.3 cm3 against 99.1 cm3; P < 0.01), hippocampus (least squares mean, 8.2 cm3 against 8.7 cm3; P = 0.01) and the cerebellum (least squares mean, 1 cm3 against 1.1 cm3; P < 0.01) compared to the pre-pandemic group.

White matter, hippocampus, and cerebellum volumes remained lower in the pandemic cohort after adjusting for maternal distress.

Moreover, the cortical area of ​​the four lobes was significantly smaller in the pandemic group compared to the pre-pandemic cohort. Local four-lobe gyrification indices were also significantly lower in the pandemic cohort, indicating less cortical folding.

The pandemic cohort also had significantly lower furrow depths in the frontal, parietal, and occipital lobes compared to the pre-pandemic cohort.

High anxiety and stress were associated with smaller hippocampal and cerebellar volumes, and higher trait anxiety was specifically associated with lower white matter volume. However, high anxiety and depression were associated with greater furrow depth.

“As we continue to elucidate the mechanisms underlying these differences, concurrent efforts should focus on implementing intervention programs for mother-infant dyads,” Limperopoulos and colleagues wrote.

Going forward, research should examine — and has already begun to examine — the long-term impacts of the pandemic on “the COVID generation of infants,” the researchers wrote.

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