No Sign Mild COVID in Pregnancy Can Harm Infant Brain
Molly E. came down with COVID last February when she was 36 weeks pregnant.
“My symptoms were mild, and after speaking to my obstetrician, I felt reassured to hear that if anything, my baby would maybe have some antibodies,” said the New Jersey resident, who did not want her last name used. Her daughter was born on March 23 and, so far, she is a normal and healthy baby.
Now, new research offers even more reassurance for moms like Molly who had mild or asymptomatic COVID-19 during their pregnancy. These toddlers showed normal learning, language and motor development skills between the ages of 5 and 11 months.
“Mild and asymptomatic COVID-19 during pregnancy does not have an effect on early neurodevelopment,” said study author Dr. Dani Dumitriu, an assistant professor of pediatrics and psychiatry at Columbia University Vagelos College of Physicians and Surgeons in New York City. “This is reassuring to the many pregnant individuals who continue to contract COVID, despite best efforts to avoid it."
According to the U.S. National Institutes of Health, mild COVID is when a patient has a fever, cough, sore throat, malaise, headache, muscle pain, nausea, vomiting, diarrhea, loss of taste and smell, but doesn't have shortness of breath, labored breathing or abnormal chest imaging.
Despite the positive findings, the jury is still out on how severe COVID infection during pregnancy affects newborns. “More data will be needed to answer this,” Dumitriu said.
For the new study, the researchers observed 407 infants between the ages of 5 and 11 months remotely by adapting a developmental assessment tool typically administered in person. Each family received the same set of baby toys and food items so that the researchers could compare the babies' fine and gross motor skills. The researchers also assessed cognitive and language skills, all without knowing which babies had been exposed to COVID.
The study took place between March 2021 and June 2022, when the pandemic was at its height. Nearly a third of the infants in the study were born to moms who had COVID during pregnancy.
Babies whose mothers had mild or asymptomatic COVID-19 at any point during pregnancy were developing similarly to those whose mothers had never had COVID, the study showed.
“The literature to date has suggested infants exposed to COVID-19 in utero are at increased risk for being born prematurely, but no other significant adverse consequences,” Dumitriu said.
“We and other groups have shown that stress during pregnancy holds a lot of risk for the infant,” she said. “Pregnant individuals, while continuing to try to avoid contracting COVID-19 [especially by vaccination], should feel reassured about this data and focus on holistic well-being.”
The study was published April 10 in the journal JAMA Network Open.
Experts agreed that the findings are largely reassuring.
Prior studies on the impact of COVID infection on infant neurodevelopmental outcomes showed conflicting results and were based on parent-reported observations of their newborn's development, said Dr. Rachel Schell, a maternal-fetal medicine fellow at the University of Texas Southwestern Medical Center in Dallas.
“The results of this study are encouraging and can be used to counsel and reassure patients with asymptomatic or mild symptoms from SARS-CoV-2 infection in pregnancy,” Schell said.
Still, pregnant patients are at increased risk for developing severe COVID compared with the non-pregnant population, she noted, and “severe SARS-CoV-2 infection during pregnancy is associated with increased adverse maternal and neonatal outcomes.”
In fact, research published just last week in the journal Pediatrics showed severe COVID during pregnancy might harm the fetal brain.
Schell's advice for pregnant women? Get vaccinated to prevent severe COVID infection during pregnancy and its potentially harmful consequences.
Dr. Joanne Stone, a professor and system chair of the Raquel and Jaime Gilinski Department of Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai in New York City.
“It is very reassuring, but the researchers just studied patients with mild or asymptomatic COVID-19 infection, so these findings can't be generalized to more severe disease,” Stone said.
Another unknown is what happens to these toddlers after 11 months, she added.
Stone advises pregnant patients to wear masks in places with high COVID case rates and wash hands regularly to stave off illness.
The U.S. National Institutes of Health offers more on how COVID-19 affects pregnancy.
SOURCES: Molly E., Jersey City, N.J.; Dani Dumitriu, MD, PhD, assistant professor, pediatrics and psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City; Rachel Schell, MD, maternal-fetal medicine fellow, University of Texas Southwestern Medical Center, Dallas; Joanne Stone, MD, professor, system chair, Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai; JAMA Network Open, April 10, 2023