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Liu Y, Ning X, Zhang L, Huang H, Zhou J, Luo Y. Post-traumatic growth in later-life cognitive function? Evidence from the 1976 Great Tangshan Earthquake. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02647-9. [PMID: 38652141 DOI: 10.1007/s00127-024-02647-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/24/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES This study aimed to explore the long-term impacts of exposure to earthquake in adolescence on later-life cognitive function in China. METHODS Data were from the 2015 China Health and Retirement Longitudinal Study (CHARLS). Our analytical sample comprised 4394 participants aged 49 to 78 from two birth cohorts born between 1937 and 1966: exposed cohort during adolescence (born between 1952 and 1966), and non-exposed cohort during adolescence (born between 1937 and 1951). We defined earthquake exposure as the exposure severity of the 1976 Great Tangshan Earthquake (GTE). We selected community environmental characteristics as our key moderators. A difference-in-differences (DID) method was employed to estimate the long-term impact of the GTE on later-life cognitive function. RESULTS We found that exposure to the earthquake during adolescence resulted in higher scores of later-life cognitive function (for males: β = 2.18; 95% CI: 0.70-3.66; for females: β = 1.22; 95% CI: 0.11-2.33). For males, this impact was moderated by community environmental characteristics including the old-age allowance program (β = 3.07; 95% CI: 1.94-4.19) and the condition of basic community infrastructures (β = 1.52; 95% CI: 0.84-2.19). CONCLUSIONS Our study supports the post-traumatic growth theory. This finding suggest that individuals with early-life traumatic exposure need to be focused on. Additionally, improving the conditions of community infrastructures and establishing a community environment with comfort and security may be pretty important for promoting cognitive function and post-traumatic growth.
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Affiliation(s)
- Yan Liu
- Institute of Population Research, Peking University, Beijing, China
| | - Xin Ning
- School of Nursing, Kunming Medical University, Yunnan, China
| | - Li Zhang
- The Geriatrics Hospital of Yunnan Province, No.38 Yuchuan Lane Commercial New Village, Tuodong Road, Guandu District, Kunming, Yunnan Province, 650011, P.R. China
| | - Hui Huang
- The Geriatrics Hospital of Yunnan Province, No.38 Yuchuan Lane Commercial New Village, Tuodong Road, Guandu District, Kunming, Yunnan Province, 650011, P.R. China
| | - Jianwei Zhou
- The Geriatrics Hospital of Yunnan Province, No.38 Yuchuan Lane Commercial New Village, Tuodong Road, Guandu District, Kunming, Yunnan Province, 650011, P.R. China.
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, P.R. China.
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2
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Cherbuin N, Bansal A, Dahlstrom JE, Carlisle H, Broom M, Nanan R, Sutherland S, Vardoulakis S, Phillips CB, Peek MJ, Christensen BK, Davis D, Nolan CJ. Bushfires and Mothers' Mental Health in Pregnancy and Recent Post-Partum. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:7. [PMID: 38276795 PMCID: PMC10815782 DOI: 10.3390/ijerph21010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/21/2023] [Accepted: 12/08/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND The compounding effects of climate change catastrophes such as bushfires and pandemics impose significant burden on individuals, societies, and their economies. The enduring effects of such syndemics on mental health remain poorly understood, particularly for at-risk populations (e.g., pregnant women and newborns). The aim of this study was to investigate the impact of direct and indirect exposure to the 2019/20 Australian Capital Territory and South-Eastern New South Wales bushfires followed by COVID-19 on the mental health and wellbeing of pregnant women and mothers with newborn babies. METHODS All women who were pregnant, had given birth, or were within three months of conceiving during the 2019/2020 bushfires, lived within the catchment area, and provided consent were invited to participate. Those who consented were asked to complete three online surveys. Mental health was assessed with the DASS-21 and the WHO-5. Bushfire, smoke, and COVID-19 exposures were assessed by self-report. Cross-sectional associations between exposures and mental health measures were tested with hierarchical regression models. RESULTS Of the women who participated, and had minimum data (n = 919), most (>75%) reported at least one acute bushfire exposure and 63% reported severe smoke exposure. Compared to Australian norms, participants had higher depression (+12%), anxiety (+35%), and stress (+43%) scores. Women with greater exposure to bushfires/smoke but not COVID-19 had poorer scores on all mental health measures. CONCLUSIONS These findings provide novel evidence that the mental health of pregnant women and mothers of newborn babies is vulnerable to major climate catastrophes such as bushfires.
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Affiliation(s)
- Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2601, Australia
| | - Amita Bansal
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia; (A.B.); (C.J.N.)
- John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
| | - Jane E. Dahlstrom
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia; (A.B.); (C.J.N.)
- John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
- The Canberra Hospital, Canberra Health Services, Garran, ACT 2605, Australia; (H.C.)
| | - Hazel Carlisle
- The Canberra Hospital, Canberra Health Services, Garran, ACT 2605, Australia; (H.C.)
| | - Margaret Broom
- The Canberra Hospital, Canberra Health Services, Garran, ACT 2605, Australia; (H.C.)
- School of Nursing and Midwifery, University of Canberra, Bruce, ACT 2617, Australia;
| | - Ralph Nanan
- Sydney Medical School and Charles Perkins Centre Nepean, University of Sydney, Penrith, NSW 2750, Australia;
| | - Stewart Sutherland
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia; (A.B.); (C.J.N.)
| | - Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2601, Australia
| | - Christine B. Phillips
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia; (A.B.); (C.J.N.)
| | - Michael J. Peek
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia; (A.B.); (C.J.N.)
| | - Bruce K. Christensen
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia; (A.B.); (C.J.N.)
| | - Deborah Davis
- School of Nursing and Midwifery, University of Canberra, Bruce, ACT 2617, Australia;
- Nursing and Midwifery Office, ACT Government Health Directorate, Phillip, ACT 2606, Australia
| | - Christopher J. Nolan
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia; (A.B.); (C.J.N.)
- John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
- The Canberra Hospital, Canberra Health Services, Garran, ACT 2605, Australia; (H.C.)
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3
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Zheng X, Luo Y. Wealth shocks and cognitive function in later life. THE LANCET. HEALTHY LONGEVITY 2023; 4:e442-e443. [PMID: 37544316 DOI: 10.1016/s2666-7568(23)00132-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Affiliation(s)
- Xiaoying Zheng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China.
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4
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Liu Y, Liu Y, Wang Y, Li Z, Luo Y. Earthquake exposure during adolescence and later-life depressive symptoms: A national cross-sectional survey. SSM Popul Health 2023; 23:101490. [PMID: 37635992 PMCID: PMC10448222 DOI: 10.1016/j.ssmph.2023.101490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 08/29/2023] Open
Abstract
Background This study aimed to examine the association between exposure to the 1976 Great Tangshan Earthquake (GTE) in adolescence and later-life depressive symptoms and to investigate the potential mechanisms underlying this association. Methods Data were from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The 10-item short form of the Center for Epidemiologic Studies Depression scale (CESD-10) was chosen to measure depressive symptoms. We used the difference-in-difference (DID) method, binary logistic regression models, and multilevel logistic regression models to explore the association of earthquake exposure during adolescence with later-life depressive symptoms. Additionally, multilevel mediation analysis with structural equation modeling (MMSEM) was conducted to investigate potential mechanisms. Results We identified that adolescent exposure to earthquakes was related to a lower risk of depressive symptoms in later life (OR = 0.90, P = 0.019; OR = 0.48, P = 0.031; OR = 0.47, P = 0.034, respectively). However, this significant association was observed only in females (OR = 0.83, P = 0.028; OR = 0.46, P = 0.053; OR = 0.42, P = 0.037, respectively). Moreover, social activity participation played a mediating role in the association between exposure to earthquakes in adolescence and later-life depressive symptoms. Conclusions We observed a lower risk of depressive symptoms in later life in survivors of earthquake exposure during adolescence. Further, we found the mediating role of social participation in the association between earthquake exposure in adolescence and later-life depressive symptoms, which gives support for the posttraumatic growth (PTG) theory. Our findings imply that, in order to lower the risk of depression in later life following exposure to a natural disaster in adolescence, it is necessary to take into account the buffering effect of social participation.
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Affiliation(s)
- Yan Liu
- Institute of Population Research, Peking University, Beijing, China
| | - Yating Liu
- School of Nursing, Peking University, Beijing, China
| | - Yantao Wang
- Institute for Crime Prevention of Ministry of Justice, China
| | - Zhuo Li
- School of Social Sciences, Tsinghua University, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China
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5
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Rubinstein MR, Burgueño AL, Quiroga S, Wald MR, Genaro AM. Current Understanding of the Roles of Gut-Brain Axis in the Cognitive Deficits Caused by Perinatal Stress Exposure. Cells 2023; 12:1735. [PMID: 37443769 PMCID: PMC10340286 DOI: 10.3390/cells12131735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/15/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
The term 'perinatal environment' refers to the period surrounding birth, which plays a crucial role in brain development. It has been suggested that dynamic communication between the neuro-immune system and gut microbiota is essential in maintaining adequate brain function. This interaction depends on the mother's status during pregnancy and/or the newborn environment. Here, we show experimental and clinical evidence that indicates that the perinatal period is a critical window in which stress-induced immune activation and altered microbiota compositions produce lasting behavioral consequences, although a clear causative relationship has not yet been established. In addition, we discuss potential early treatments for preventing the deleterious effect of perinatal stress exposure. In this sense, early environmental enrichment exposure (including exercise) and melatonin use in the perinatal period could be valuable in improving the negative consequences of early adversities. The evidence presented in this review encourages the realization of studies investigating the beneficial role of melatonin administration and environmental enrichment exposure in mitigating cognitive alteration in offspring under perinatal stress exposure. On the other hand, direct evidence of microbiota restoration as the main mechanism behind the beneficial effects of this treatment has not been fully demonstrated and should be explored in future studies.
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Affiliation(s)
- Mara Roxana Rubinstein
- Laboratorio de Psiconeuroendocrinoinmunologia, Instituto de Investigaciones Biomédicas, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)—Pontificia Universidad Católica Argentina, Buenos Aires C1107AFF, Argentina; (A.L.B.); (S.Q.); (M.R.W.)
| | | | | | | | - Ana María Genaro
- Laboratorio de Psiconeuroendocrinoinmunologia, Instituto de Investigaciones Biomédicas, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)—Pontificia Universidad Católica Argentina, Buenos Aires C1107AFF, Argentina; (A.L.B.); (S.Q.); (M.R.W.)
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6
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Fan W, Zlatnik MG. Climate Change and Pregnancy: Risks, Mitigation, Adaptation, and Resilience. Obstet Gynecol Surv 2023; 78:223-236. [PMID: 37043299 PMCID: PMC10508966 DOI: 10.1097/ogx.0000000000001116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Importance Climate change is affecting the earth, resulting in more extreme temperatures and weather, rising sea levels, more frequent natural disasters, and displacement of populations of plants and animals, including people and insects. These changes affect food and housing security, vector-borne illnesses, and access to clean air and water, all of which influence human health. Evidence and Results There are a number of adverse health outcomes linked to heat, air pollution from wildfires, stress from natural disasters, and other elements of climate change. Pregnant people are especially vulnerable to the health harms resulting from climate change, namely, preterm birth, small for gestational age, hypertensive disorders of pregnancy, and other adverse reproductive health and birth outcomes. Strategies to minimize these harms include mitigation and adaptation. Conclusions and Relevance Physicians are in a unique position to protect the health of pregnant persons and children by advocating for policy changes that address climate change and providing clinical recommendations for patients to protect themselves from the health impacts of climate hazards.
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Affiliation(s)
| | - Marya G Zlatnik
- Professor, Maternal Fetal Medicine, Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, Western States Pediatric Environmental Health Specialty Unit, University of California San Francisco, San Francisco, CA
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7
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Ramesh B, Callender R, Zaitchik BF, Jagger M, Swarup S, Gohlke JM. Adverse Health Outcomes Following Hurricane Harvey: A Comparison of Remotely-Sensed and Self-Reported Flood Exposure Estimates. GEOHEALTH 2023; 7:e2022GH000710. [PMID: 37091294 PMCID: PMC10120588 DOI: 10.1029/2022gh000710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 02/10/2023] [Accepted: 03/21/2023] [Indexed: 05/03/2023]
Abstract
Remotely sensed inundation may help to rapidly identify areas in need of aid during and following floods. Here we evaluate the utility of daily remotely sensed flood inundation measures and estimate their congruence with self-reported home flooding and health outcomes collected via the Texas Flood Registry (TFR) following Hurricane Harvey. Daily flood inundation for 14 days following the landfall of Hurricane Harvey was acquired from FloodScan. Flood exposure, including number of days flooded and flood depth was assigned to geocoded home addresses of TFR respondents (N = 18,920 from 47 counties). Discordance between remotely-sensed flooding and self-reported home flooding was measured. Modified Poisson regression models were implemented to estimate risk ratios (RRs) for adverse health outcomes following flood exposure, controlling for potential individual level confounders. Respondents whose home was in a flooded area based on remotely-sensed data were more likely to report injury (RR = 1.5, 95% CI: 1.27-1.77), concentration problems (1.36, 95% CI: 1.25-1.49), skin rash (1.31, 95% CI: 1.15-1.48), illness (1.29, 95% CI: 1.17-1.43), headaches (1.09, 95% CI: 1.03-1.16), and runny nose (1.07, 95% CI: 1.03-1.11) compared to respondents whose home was not flooded. Effect sizes were larger when exposure was estimated using respondent-reported home flooding. Near-real time remote sensing-based flood products may help to prioritize areas in need of assistance when on the ground measures are not accessible.
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Affiliation(s)
- Balaji Ramesh
- College of Public HealthThe Ohio State UniversityColumbusOHUSA
| | | | - Benjamin F. Zaitchik
- Department of Earth and Planetary SciencesJohns Hopkins UniversityBaltimoreMDUSA
| | | | - Samarth Swarup
- Biocomplexity InstituteUniversity of VirginiaCharlottesvilleVAUSA
| | - Julia M. Gohlke
- Department of Population Health SciencesVirginia TechBlacksburgVAUSA
- Environmental Defense FundWashingtonDCUSA
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8
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Guo C. Support strategies for pregnant women and their offspring in disaster events. Int J Gynaecol Obstet 2023; 160:335-337. [PMID: 35965406 DOI: 10.1002/ijgo.14404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/22/2022] [Accepted: 08/09/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Chao Guo
- Institute of Population Research, Peking University, Beijing, China.,APEC Health Science Academy, Peking University, Beijing, China
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9
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Zheng X, Luo Y, Su B, He P, Guo C, Tian Y, Han S, Chen C, Wang Y, Liu J, Li J. Developmental Gerontology and Active Population Aging in China. China CDC Wkly 2023; 5:184-187. [PMID: 37008673 PMCID: PMC10061737 DOI: 10.46234/ccdcw2023.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/12/2022] [Indexed: 02/26/2023] Open
Abstract
Population aging is an irreversible process in the development of modern society, which brings challenges to comprehensive modernized social governance. Population aging is a "dualistic" development issue that not only leads to aging of the labor force structure but also creates new demographic dividends. This study describes the core thoughts of developmental gerontology (DG), which provides new insight into the relationship between active aging and comprehensive governance for modernized society. The development of DG will provide a feasible and sustainable path to integrate and coordinate the relationship between population aging, society, and economy.
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Affiliation(s)
- Xiaoying Zheng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing Municipality, China
- Zheng Xiaoying,
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing Municipality, China
| | - Binbin Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing Municipality, China
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing Municipality, China
| | - Chao Guo
- APEC Health Science Academy, Peking University, Beijing Municipality, China
| | - Yaohua Tian
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shasha Han
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing Municipality, China
| | - Chen Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing Municipality, China
| | - Yiran Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing Municipality, China
- APEC Health Science Academy, Peking University, Beijing Municipality, China
| | - Jufen Liu
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing Municipality, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing Municipality, China
| | - Jun Li
- Institute of Economics, Chinese Academy of Social Sciences, Beijing Municipality, China
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10
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Ssewanyana D, Knight JA, Matthews SG, Wong J, Khani NA, Lye J, Murphy KE, Foshay K, Okeke J, Lye SJ, Hung RJ. Maternal prenatal psychological distress and vitamin intake with children's neurocognitive development. Pediatr Res 2022; 92:1450-1457. [PMID: 35288638 DOI: 10.1038/s41390-022-02003-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/06/2022] [Accepted: 02/06/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Maternal prenatal psychological distress (PPD) is increasingly linked to sub-optimal child neurodevelopment. Daily intake of prenatal vitamin during pre-conception and early pregnancy may ameliorate the effects of PPD on cognition in the offspring. METHODS PPD was assessed in early (12-16 weeks) and late (28-32 weeks) gestation in the Ontario Birth Study. Prenatal vitamin supplement intake information was collected in early gestation. Child cognition at 4 years was assessed using the NIH Toolbox. Poisson regression was used to investigate associations between PPD and/or prenatal vitamin intake and child cognition. RESULTS Four hundred and eighteen mother-child dyads were assessed. Moderate-severe PPD experienced during early gestation was associated with reduced cognition (adjusted incidence rate ratio (IRRadj) = 3.71, 95% confidence interval (CI): 1.57-8.77, P = 0.003). Daily intake of prenatal vitamins was not associated with cognition (IRRadj = 1.34, 95% CI: 0.73-2.46, P = 0.34). Upon stratification, the experience of mild-severe PPD with daily intake of prenatal vitamins was associated with higher incident rates of suboptimal cognition compared to children of women with daily prenatal vitamin intake without any episode of PPD (IRRadj = 2.88, 95% CI: 1.1-7.4). CONCLUSIONS Moderate-severe PPD in early pregnancy is associated with poor cognition in children and daily intake of prenatal vitamin did not ameliorate this association. IMPACT Our findings expand on existing literature by highlighting that exposure to prenatal psychological distress (PPD), in moderate-to-severe form, in the early stages of pregnancy, can have detrimental effects on the offspring's cognitive development at 4 years. Overall, prenatal vitamin intake did not ameliorate the effects of PPD. Early screening and treatment of prenatal maternal mental illness is crucial.
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Affiliation(s)
- Derrick Ssewanyana
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.,Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Julia A Knight
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Stephen G Matthews
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.,Department of Physiology, University of Toronto, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.,Department of Obstetrics and Gynaecology, Sinai Health System, Toronto, ON, Canada
| | - Jody Wong
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Nadya Adel Khani
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Jennifer Lye
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Kellie E Murphy
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.,Department of Obstetrics and Gynaecology, Sinai Health System, Toronto, ON, Canada
| | - Kim Foshay
- Department of Obstetrics and Gynaecology, Sinai Health System, Toronto, ON, Canada
| | - Justin Okeke
- Department of Obstetrics and Gynaecology, Sinai Health System, Toronto, ON, Canada
| | - Stephen J Lye
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.,Department of Physiology, University of Toronto, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.,Department of Obstetrics and Gynaecology, Sinai Health System, Toronto, ON, Canada
| | - Rayjean J Hung
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada. .,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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11
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Shuffrey LC, Firestein MR, Kyle MH, Fields A, Alcántara C, Amso D, Austin J, Bain JM, Barbosa J, Bence M, Bianco C, Fernández CR, Goldman S, Gyamfi-Bannerman C, Hott V, Hu Y, Hussain M, Factor-Litvak P, Lucchini M, Mandel A, Marsh R, McBrian D, Mourad M, Muhle R, Noble KG, Penn AA, Rodriguez C, Sania A, Silver WG, O’Reilly KC, Stockwell M, Tottenham N, Welch MG, Zork N, Fifer WP, Monk C, Dumitriu D. Association of Birth During the COVID-19 Pandemic With Neurodevelopmental Status at 6 Months in Infants With and Without In Utero Exposure to Maternal SARS-CoV-2 Infection. JAMA Pediatr 2022; 176:e215563. [PMID: 34982107 PMCID: PMC8728661 DOI: 10.1001/jamapediatrics.2021.5563] [Citation(s) in RCA: 117] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
IMPORTANCE Associations between in utero exposure to maternal SARS-CoV-2 infection and neurodevelopment are speculated, but currently unknown. OBJECTIVE To examine the associations between maternal SARS-CoV-2 infection during pregnancy, being born during the COVID-19 pandemic regardless of maternal SARS-CoV-2 status, and neurodevelopment at age 6 months. DESIGN, SETTING, AND PARTICIPANTS A cohort of infants exposed to maternal SARS-CoV-2 infection during pregnancy and unexposed controls was enrolled in the COVID-19 Mother Baby Outcomes Initiative at Columbia University Irving Medical Center in New York City. All women who delivered at Columbia University Irving Medical Center with a SARS-CoV-2 infection during pregnancy were approached. Women with unexposed infants were approached based on similar gestational age at birth, date of birth, sex, and mode of delivery. Neurodevelopment was assessed using the Ages & Stages Questionnaire, 3rd Edition (ASQ-3) at age 6 months. A historical cohort of infants born before the pandemic who had completed the 6-month ASQ-3 were included in secondary analyses. EXPOSURES Maternal SARS-CoV-2 infection during pregnancy and birth during the COVID-19 pandemic. MAIN OUTCOMES AND MEASURES Outcomes were scores on the 5 ASQ-3 subdomains, with the hypothesis that maternal SARS-CoV-2 infection during pregnancy would be associated with decrements in social and motor development at age 6 months. RESULTS Of 1706 women approached, 596 enrolled; 385 women were invited to a 6-month assessment, of whom 272 (70.6%) completed the ASQ-3. Data were available for 255 infants enrolled in the COVID-19 Mother Baby Outcomes Initiative (114 in utero exposed, 141 unexposed to SARS-CoV-2; median maternal age at delivery, 32.0 [IQR, 19.0-45.0] years). Data were also available from a historical cohort of 62 infants born before the pandemic. In utero exposure to maternal SARS-CoV-2 infection was not associated with significant differences on any ASQ-3 subdomain, regardless of infection timing or severity. However, compared with the historical cohort, infants born during the pandemic had significantly lower scores on gross motor (mean difference, -5.63; 95% CI, -8.75 to -2.51; F1,267 = 12.63; P<.005), fine motor (mean difference, -6.61; 95% CI, -10.00 to -3.21; F1,267 = 14.71; P < .005), and personal-social (mean difference, -3.71; 95% CI, -6.61 to -0.82; F1,267 = 6.37; P<.05) subdomains in fully adjusted models. CONCLUSIONS AND RELEVANCE In this study, birth during the pandemic, but not in utero exposure to maternal SARS-CoV-2 infection, was associated with differences in neurodevelopment at age 6 months. These early findings support the need for long-term monitoring of children born during the COVID-19 pandemic.
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Affiliation(s)
- Lauren C. Shuffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Morgan R. Firestein
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Margaret H. Kyle
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Andrea Fields
- Department of Psychology, Columbia University, New York, New York
| | | | - Dima Amso
- Department of Psychology, Columbia University, New York, New York
| | - Judy Austin
- Heilbrunn Department of Population and Family Health, Columbia University Irving Medical Center, New York, New York
| | - Jennifer M. Bain
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, New York
| | - Jennifer Barbosa
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Mary Bence
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Catherine Bianco
- Department of Psychology, Columbia University, New York, New York
| | - Cristina R. Fernández
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Sylvie Goldman
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, New York
| | - Cynthia Gyamfi-Bannerman
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla
| | - Violet Hott
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Yunzhe Hu
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Maha Hussain
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
| | - Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Arthur Mandel
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, New York
| | - Rachel Marsh
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Danielle McBrian
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, New York
| | - Mirella Mourad
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center New York, New York
| | - Rebecca Muhle
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Kimberly G. Noble
- Department of Neuroscience and Education, Teachers College, Columbia University, New York, New York
| | - Anna A. Penn
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | | | - Ayesha Sania
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Wendy G. Silver
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, New York
| | - Kally C. O’Reilly
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York,New York State Psychiatric Institute, New York
| | - Melissa Stockwell
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Nim Tottenham
- Department of Psychology, Columbia University, New York, New York
| | - Martha G. Welch
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York,Department of Pediatrics, Columbia University Irving Medical Center, New York, New York,Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York
| | - Noelia Zork
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center New York, New York
| | - William P. Fifer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York,Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Catherine Monk
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York,Department of Obstetrics and Gynecology, Columbia University Irving Medical Center New York, New York
| | - Dani Dumitriu
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York,Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
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Abstract
PURPOSE OF REVIEW To evaluate the available literature regarding effects of coronavirus disease 2019 (COVID-19) on newborns, ranging from effects related to in utero and perinatal exposure to maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, to pandemic-related stress and socioeconomic changes. RECENT FINDINGS Several large studies and national registries have shown that the risk of vertical transmission from SARS-CoV-2-infected mothers to newborns is rare and does not appear to be related to postnatal care policies such as mother-newborn separation and breastfeeding. Newborns exposed to SARS-CoV-2 in utero are at higher risk for preterm delivery for reasons still under investigation. When newborns do acquire SARS-CoV-2 infection, their disease course is usually mild. Long-term follow-up data are lacking, but preliminary reports indicate that, similarly to prior natural disasters, being born during the pandemic may be associated with developmental risk. SUMMARY Although risk of vertical or perinatal transmission is low across a range of postnatal care practices, early indicators suggest developmental risk to the generation born during the pandemic. Long-term follow-up data are critically needed to determine the developmental impact of in utero and early life exposure to SARS-CoV-2 and the COVID-19 pandemic.
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Affiliation(s)
| | - Dani Dumitriu
- Department of Pediatrics
- Department of Psychiatry
- Nurture Science Program, Columbia University Irving Medical Center, New York, New York, USA
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13
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Guo C, Zheng X. Prenatal exposure to the SARS epidemic emergency and risk of cognitive impairment in toddlers. Sci Bull (Beijing) 2021; 66:2153-2156. [PMID: 33898077 PMCID: PMC8056975 DOI: 10.1016/j.scib.2021.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Chao Guo
- Institute of Population Research & APEC Health Science Academy, Peking University China
| | - Xiaoying Zheng
- Institute of Population Research & APEC Health Science Academy, Peking University China
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