Sex-Specific Neurodevelopmental Outcomes Among Offspring of Mothers With SARS-CoV-2 Infection During Pregnancy

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(3), P. e234415 - e234415

Published: March 23, 2023

Importance Prior 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 may be sex-specific. Objective To determine whether utero exposure to SARS-CoV-2 is associated sex-specific disorders up 18 months after birth, compared unexposed offspring born or prior the COVID-19 pandemic period. Design, Setting, Participants This retrospective cohort study included live all who delivered between January 1 December 31, 2018 (born followed before pandemic), March 2019 1, 2020, May 2021 pandemic). Offspring were at any 8 hospitals across 2 health systems Massachusetts. Exposures Polymerase chain reaction evidence maternal infection pregnancy. Main Outcomes Measures Electronic record documentation International Statistical Classification Diseases Related Health Problems, Tenth Revision diagnostic codes corresponding disorders. Results The 355 births (9399 boys [51.2%]), including 883 (4.8%) positivity 1809 Asian individuals (9.9%), 1635 Black (8.9%), 12 718 White (69.3%), 1714 (9.3%) other race (American Indian Alaska Native, Native Hawaiian Pacific Islander, more than race); 2617 (14.3%) Hispanic ethnicity. Mean age was 33.0 (IQR, 30.0-36.0) years. In adjusted regression models accounting race, ethnicity, insurance status, hospital type (academic center vs community), age, preterm statistically significant elevation male (adjusted OR, 1.94 [95% CI 1.12-3.17]; P = .01) but not female 0.89 CI, 0.39-1.76]; .77). Similar effects identified matched analyses lieu regression. At months, observed 1.42 0.92-2.11]; .10). Conclusions Relevance this utero, greater magnitude following birth. As infection, substantially larger cohorts longer follow-up will required reliably estimate refute risk.

Language: Английский

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Maternal immune activation and role of placenta in the prenatal programming of neurodevelopmental disorders

Neuronal Signaling, Journal Year: 2023, Volume and Issue: 7(2)

Published: May 17, 2023

Maternal infection during pregnancy, leading to maternal immune activation (mIA) and cytokine release, increases the offspring risk of developing a variety neurodevelopmental disorders (NDDs), including schizophrenia. Animal models have provided evidence support these mechanistic links, with placental inflammatory responses dysregulation function implicated. This leads changes in fetal brain balance altered epigenetic regulation key pathways. The prenatal timing such mIA-evoked changes, accompanying developmental an

Language: Английский

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Viral infections in pregnancy and impact on offspring neurodevelopment: mechanisms and lessons learned

Pediatric Research, Journal Year: 2024, Volume and Issue: 96(1), P. 64 - 72

Published: March 20, 2024

Language: Английский

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In Utero Exposure to Maternal COVID-19 Vaccination and Offspring Neurodevelopment at 12 and 18 Months

JAMA Pediatrics, Journal Year: 2024, Volume and Issue: 178(3), P. 258 - 258

Published: Jan. 22, 2024

Importance Uptake of COVID-19 vaccines among pregnant individuals was hampered by safety concerns around potential risks to unborn children. Data clarifying early neurodevelopmental outcomes offspring exposed vaccination in utero are lacking. Objective To determine whether exposure maternal associated with differences scores on the Ages and Stages Questionnaire, third edition (ASQ-3), at 12 18 months age. Design, Setting, Participants This prospective cohort study, Assessing Safety Pregnancy During Coronavirus Pandemic (ASPIRE), enrolled participants from May 2020 August 2021; follow-up children these pregnancies is ongoing. Participants, which included their all 50 states, self-enrolled online. Study activities were performed remotely. Exposure In fetus during pregnancy compared those unexposed. Main Outcomes Measures Neurodevelopmental validated ASQ-3, completed birth mothers months. A score below established cutoff any 5 subdomains (communication, gross motor, fine problem solving, social skills) constituted an abnormal screen for developmental delay. Results total 2487 (mean [SD] age, 33.3 [4.2] years) less than 10 weeks’ gestation research activities, yielding a 2261 1940 infants aged months, respectively, assessments. crude analyses, 471 1541 (30.6%) screened abnormally delay vs 203 720 unexposed (28.2%; χ 2 = 1.32; P .25); corresponding prevalences 262 1301 (20.1%) 148 639 (23.2%), respectively (χ 2.35; .13). multivariable mixed-effects logistic regression models adjusting race, ethnicity, education, income, depression, anxiety, no difference risk ASQ-3 screens observed either time point (12 months: adjusted ratio [aRR], 1.14; 95% CI, 0.97-1.33; aRR, 0.88; 0.72-1.07). Further adjustment preterm infant sex did not affect results 1.16; 0.98-1.36; 0.87; 0.71-1.07). Conclusions Relevance this study suggest that safe perspective neurodevelopment Additional longer-term should be conducted corroborate findings buttress clinical guidance strong evidence base.

Language: Английский

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SARS-CoV-2 niches in human placenta revealed by spatial transcriptomics

Med, Journal Year: 2023, Volume and Issue: 4(9), P. 612 - 634.e4

Published: July 8, 2023

BackgroundFunctional placental niches are presumed to spatially separate maternal-fetal antigens and restrict the vertical transmission of pathogens. We hypothesized a high-resolution map transcription could provide direct evidence for niche microenvironments with unique functions profiles.MethodsWe utilized Visium Spatial Transcriptomics paired H&E staining generate 17,927 spatial transcriptomes. By integrating these transcriptomes 273,944 single-cell single-nuclei transcriptomes, we generated an atlas composed at least 22 subpopulations in maternal decidua, fetal chorionic villi, chorioamniotic membranes.FindingsComparisons placentae from uninfected healthy controls (n = 4) COVID-19 asymptomatic symptomatic 5) infected participants demonstrated that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection syncytiotrophoblasts occurred both presence absence clinical disease. With transcriptomics, found limit SARS-CoV-2 was 1/7,000 cells, without detectable viral transcripts were unperturbed. In contrast, high transcript levels associated significant upregulation pro-inflammatory cytokines interferon-stimulated genes, altered metallopeptidase signaling (TIMP1), coordinated shifts macrophage polarization, histiocytic intervillositis, perivillous fibrin deposition. Fetal sex differences gene expression responses limited, confirmed mapping limited decidua males.ConclusionsHigh-resolution transcriptomics resolution revealed dynamic coordinate clinically evident disease.FundingThis work supported by NIH (R01HD091731 T32-HD098069), NSF (2208903), Burroughs Welcome Fund March Dimes Preterm Birth Research Initiatives, Career Development Award American Society Gene Cell Therapy.

Language: Английский

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Global prevalence of poor sleep quality in military personnel and veterans: A systematic review and meta-analysis of epidemiological studies

Sleep Medicine Reviews, Journal Year: 2023, Volume and Issue: 71, P. 101840 - 101840

Published: Aug. 19, 2023

Language: Английский

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Neurodevelopmental outcomes in congenital and perinatal infections

Current Opinion in Infectious Diseases, Journal Year: 2023, Volume and Issue: 36(5), P. 405 - 413

Published: July 19, 2023

Congenital infections are a major cause of childhood multidomain neurodevelopmental disabilities. They contribute to range structural brain abnormalities that can severe impairment, cerebral palsy, epilepsy, and neurosensory impairments. New congenital global viral pandemics have emerged, with some affecting the developing causing concerns. This review aims provide current understanding fetal their impact on neurodevelopment.

Language: Английский

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Evidence linking COVID-19 and the health/well-being of children and adolescents: an umbrella review

BMC Medicine, Journal Year: 2024, Volume and Issue: 22(1)

Published: March 13, 2024

Abstract Background Experiences during childhood and adolescence have enduring impacts on physical mental well-being, overall quality of life, socioeconomic status throughout one’s lifetime. This underscores the importance prioritizing health children adolescents to establish an impactful healthcare system that benefits both individuals society. It is crucial for providers policymakers examine relationship between COVID-19 adolescents, as this understanding will guide creation interventions policies long-term management virus. Methods In umbrella review (PROSPERO ID: CRD42023401106), systematic reviews were identified from Cochrane Database Systematic Reviews; EMBASE (OvidSP); MEDLINE (OvidSP) December 2019 February 2023. Pairwise single-arm meta-analyses extracted included reviews. The methodological appraisal was completed using AMSTAR-2 tool. Single-arm re-presented under six domains associated with condition. classified into five according evidence classification criteria. Rosenberg’s FSN calculated binary continuous measures. Results We 1551 301 pairwise 124 met our predefined criteria inclusion. focus meta-analytical predominantly outcomes COVID-19, encompassing study designs. However, rigor suboptimal. Based gathered meta-analyses, we constructed illustrative representation disease severity, clinical manifestations, laboratory radiological findings, treatments, 2020 2022. Additionally, discovered 17 instances strong or highly suggestive concerning long-COVID, pediatric comorbidity, vaccines, health, depression. Conclusions findings advocate implementation surveillance systems track consequences establishment multidisciplinary collaborative rehabilitation programs affected younger populations. future research endeavors, it important prioritize investigation non-physical bridge gap application in field.

Language: Английский

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Developmental and behavioural outcomes at 2 years in babies born during the COVID-19 pandemic: communication concerns in a pandemic birth cohort

Archives of Disease in Childhood, Journal Year: 2023, Volume and Issue: 108(10), P. 846 - 851

Published: June 21, 2023

The CORAL (Impact of Corona Virus Pandemic on Allergic and Autoimmune Dysregulation in Infants Born During Lockdown) study reported a reduction social communication milestones 12-month-old infants born into the COVID-19 pandemic.To look at 24-month developmental behavioural outcomes cohort.The is longitudinal prospective observational Irish first 3 months pandemic. At 24 age, Ages Stages Developmental Questionnaire (ASQ24) Child Behaviour Checklist (CBCL) were completed compared with prepandemic BASELINE (Babies After SCOPE: Evaluating Longitudinal Impact Using Neurological Nutritional Impact) cohort.917 babies (312 605 infants) included. cohorts had similar ASQ24 scores fine motor, problem solving personal domains but significantly lower group cohort (mean (SD) 49.5 (15.1) vs 53.7 (11.6), p<0.01). from more likely to score below standardised cut-offs for concern domain (11.9% 5.4% BASELINE, Unadjusted gross motor pandemic cohort. Fewer fell under 2 SD cut-off personal-social subdomain. For CBCL, there was no evidence difference between multivariable analysis.24-month-old pandemic-born largely their counterparts. Concerns have been raised domain.

Language: Английский

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In Utero Exposure to Maternal COVID-19 and Offspring Neurodevelopment Through Age 24 Months

JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(10), P. e2439792 - e2439792

Published: Oct. 16, 2024

Importance In utero exposure to maternal infections has been associated with abnormal neurodevelopment among offspring. The emergence of a new, now endemic infection (SARS-CoV-2) warrants investigating developmental implications for exposed Objective To assess whether in COVID-19 is neurodevelopmental scores children ages 12, 18, and 24 months. Design, Setting, Participants Data were ascertained from the ASPIRE (Assessing Safety Pregnancy Coronavirus Pandemic) trial, prospective cohort pregnant individuals aged 18 years or older who enrolled before 10 weeks’ gestation their children. Individuals recruited online May 14, 2020, August 23, 2021, using Society Assisted Reproductive Technology BabyCenter, an media platform. all 50 states Puerto Rico completed activities remotely. Exposure COVID-19. Main Outcomes Measures Birth mothers Ages &amp;amp; Stages Questionnaires, Third Edition, validated screening tool delays, at months’ post partum. A score below cutoff any domain (communication, gross motor, fine problem-solving, social skills) was considered screen (scores range 0 60 each domain, higher indicating less risk delay). Results included 2003 (mean [SD] age, 33.3 [4.2] years) study activities; 1750 (87.4%) had earned college degree. Neurodevelopmental outcomes available 1757 age 12 months, 1522 1523 prevalence screens vs unexposed offspring months 64 198 (32.3%) 458 1559 (29.4%); 36 161 (22.4%) 279 1361 (20.5%); 29 151 (19.2%) 230 1372 (16.8%). adjusted mixed-effects logistics regression model, no difference observed (adjusted ratio [ARR], 1.07 [95% CI, 0.85-1.34]), (ARR, 1.15 0.84-1.57]), 1.01 0.69-1.48]). Supplemental analyses did not identify differential based on trimester infection, presence absence fever, breakthrough following vaccination primary infection. Conclusions Relevance this offspring, results through Continued diverse groups needed because, other factors, evidence suggests sensitivity developing fetal brain immune activation.

Language: Английский

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