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Hill RA, Malhotra A, Sackett V, Williams K, Fahey M, Palmer KR, Hunt RW, Darke H, Lim I, Newman-Morris V, Cheong JLY, Whitehead C, Said J, Bignardi P, Muraguchi E, Fernandes LCC, Oliveira C, Sundram S. A prospective, longitudinal, case-control study to evaluate the neurodevelopment of children from birth to adolescence exposed to COVID-19 in utero. BMC Pediatr 2023; 23:48. [PMID: 36717903 PMCID: PMC9885906 DOI: 10.1186/s12887-023-03858-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 01/19/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The Coronavirus disease (COVID-19) pandemic has created unprecedented acute global health challenges. However, it also presents a set of unquantified and poorly understood risks in the medium to long term, specifically, risks to children whose mothers were infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy. Infections during pregnancy can increase the risk of atypical neurodevelopment in the offspring, but the long-term neurodevelopmental impact of in utero COVID-19 exposure is unknown. Prospective, longitudinal studies are needed to evaluate children exposed in utero to SARS-CoV2 to define this risk. METHODS We have designed a prospective, case-controlled study to investigate the long-term impacts of SARS-CoV2 exposure on children exposed in utero. Women infected with SARS-CoV-2 during pregnancy will be recruited from Monash Health, the Royal Women's Hospital and Western Health (Melbourne, Australia) and Londrina Municipal Maternity Hospital Lucilla Ballalai and PUCPR Medical Clinical (Londrina, Brazil). A control group in a 2:1 ratio (2 non-exposed: 1 exposed mother infant dyad) comprising women who gave birth in the same month of delivery, are of similar age but did not contract SARS-CoV-2 during their pregnancy will also be recruited. We aim to recruit 170 exposed and 340 non-exposed mother-infant dyads. Clinical and socio-demographic data will be collected directly from the mother and medical records. Biospecimens and clinical and epidemiological data will be collected from the mothers and offspring at multiple time points from birth through to 15 years of age using standardised sample collection, and neurological and behavioural measures. DISCUSSION The mapped neurodevelopmental trajectories and comparisons between SARS-CoV-2 exposed and control children will indicate the potential for an increase in atypical neurodevelopment. This has significant implications for strategic planning in the mental health and paediatrics sectors and long-term monitoring of children globally.
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Affiliation(s)
- Rachel A. Hill
- grid.1002.30000 0004 1936 7857Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Level 3, 27-31 Wright St, Clayton, VIC 3168 Australia ,grid.1008.90000 0001 2179 088XFlorey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC Australia
| | - Atul Malhotra
- grid.1002.30000 0004 1936 7857Department of Paediatrics, Monash University, Clayton, VIC Australia
| | - Vathana Sackett
- grid.1002.30000 0004 1936 7857Department of Paediatrics, Monash University, Clayton, VIC Australia
| | - Katrina Williams
- grid.1002.30000 0004 1936 7857Department of Paediatrics, Monash University, Clayton, VIC Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, The University of Melbourne, Parkville, VIC Australia ,grid.1008.90000 0001 2179 088XDepartment of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC Australia
| | - Michael Fahey
- grid.1002.30000 0004 1936 7857Department of Paediatrics, Monash University, Clayton, VIC Australia
| | - Kirsten R. Palmer
- grid.419789.a0000 0000 9295 3933Monash Women’s, Monash Health, Clayton, VIC Australia ,grid.1002.30000 0004 1936 7857Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC Australia
| | - Rod W. Hunt
- grid.1002.30000 0004 1936 7857Department of Paediatrics, Monash University, Clayton, VIC Australia ,grid.1058.c0000 0000 9442 535XClinical Sciences, Murdoch Children’s Research Institute, Parkville, VIC Australia
| | - Hayley Darke
- grid.1002.30000 0004 1936 7857Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Level 3, 27-31 Wright St, Clayton, VIC 3168 Australia
| | - Izaak Lim
- grid.1002.30000 0004 1936 7857Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Level 3, 27-31 Wright St, Clayton, VIC 3168 Australia ,grid.419789.a0000 0000 9295 3933Monash Medical Centre, Early in Life Mental Health Service, Monash Health, Clayton, VIC Australia
| | - Vesna Newman-Morris
- grid.1002.30000 0004 1936 7857Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Level 3, 27-31 Wright St, Clayton, VIC 3168 Australia ,grid.419789.a0000 0000 9295 3933Monash Medical Centre, Early in Life Mental Health Service, Monash Health, Clayton, VIC Australia
| | - Jeanie L. Y. Cheong
- grid.1008.90000 0001 2179 088XDepartment of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC Australia ,grid.1058.c0000 0000 9442 535XClinical Sciences, Murdoch Children’s Research Institute, Parkville, VIC Australia ,grid.416259.d0000 0004 0386 2271Department of Neonatal Services, Royal Women’s Hospital, Parkville, VIC Australia
| | - Clare Whitehead
- grid.1008.90000 0001 2179 088XDepartment of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC Australia ,grid.416259.d0000 0004 0386 2271Department of Obstetrics and Gynaecology, Royal Women’s Hospital, Parkville, VIC Australia
| | - Joanne Said
- grid.1008.90000 0001 2179 088XDepartment of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC Australia ,grid.490467.80000000405776836Maternal Fetal Medicine, Joan Kirner Women’s & Children’s at Sunshine Hospital, Western Health, Sunshine, VIC Australia
| | - Paulo Bignardi
- grid.412522.20000 0000 8601 0541School of Medicine, Pontifical Catholic University of Paraná, Londrina, Paraná, Brazil
| | - Evelin Muraguchi
- grid.412522.20000 0000 8601 0541School of Medicine, Pontifical Catholic University of Paraná, Londrina, Paraná, Brazil
| | - Luiz Carlos C. Fernandes
- grid.412522.20000 0000 8601 0541School of Medicine, Pontifical Catholic University of Paraná, Londrina, Paraná, Brazil
| | - Carlos Oliveira
- grid.412522.20000 0000 8601 0541School of Medicine, Pontifical Catholic University of Paraná, Londrina, Paraná, Brazil
| | - Suresh Sundram
- grid.1002.30000 0004 1936 7857Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Level 3, 27-31 Wright St, Clayton, VIC 3168 Australia ,grid.419789.a0000 0000 9295 3933Mental Health Program, Monash Health, Melbourne, VIC Australia
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Lim I, Newman-Morris V, Hill R, Hoehn E, Kowalenko N, Matacz R, Paul C, Powrie R, Priddis L, Raykar V, Wright T, Newman L, Sundram S. You can't have one without the other: The case for integrated perinatal and infant mental health services. Aust N Z J Psychiatry 2022; 56:586-588. [PMID: 35257590 DOI: 10.1177/00048674221083874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Izaak Lim
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.,Early in Life Mental Health Service, Monash Medical Centre, Monash Health, Clayton, VIC, Australia
| | - Vesna Newman-Morris
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.,Early in Life Mental Health Service, Monash Medical Centre, Monash Health, Clayton, VIC, Australia
| | - Rebecca Hill
- Perinatal and Infant Mental Health Services, Women's and Children's Health Network, Adelaide, SA, Australia.,Department of Psychiatry, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Elisabeth Hoehn
- Queensland Centre for Perinatal and Infant Mental Health, Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
| | - Nicholas Kowalenko
- Emerging Minds & Tresillian Family Care Services, Sydney, NSW, Australia
| | - Rochelle Matacz
- School of Arts and Humanities, Pregnancy to Parenthood Clinic, Edith Cowan University, Perth, WA, Australia
| | - Campbell Paul
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.,Mental Health Service, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Rosalind Powrie
- Perinatal and Infant Mental Health Services, Women's and Children's Health Network, Adelaide, SA, Australia
| | - Lynn Priddis
- Law School, University of Western Australia, Perth, WA, Australia
| | - Vibhay Raykar
- Child and Adolescent Mental Health Service, Goulburn Valley Health, Shepparton, VIC, Australia.,Department of Rural Health, University of Melbourne, Shepparton, VIC, Australia
| | - Tanya Wright
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Perinatal, Infant and Te Puawaitanga Mental Health Services, Counties Manukau District Health Board, Auckland, New Zealand
| | - Louise Newman
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.,Mental Health Program, Monash Health, Melbourne, VIC, Australia
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Newman-Morris V, Simpson K, Gray KM, Perry N, Dunlop A, Newman LK. Evaluation of early relational disturbance in high-risk populations: Borderline personality disorder features, maternal mental state, and observed interaction. Infant Ment Health J 2020; 41:793-810. [PMID: 32602964 DOI: 10.1002/imhj.21880] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Despite the longstanding theoretical association in the attachment literature between maternal trauma history and disturbances in the mother-infant interaction, few studies have investigated mechanisms of transmission of traumatogenic relational patterns in high-risk mother-infant dyads. This study investigated interrelationships among maternal trauma history, distorted maternal representations (DMRs, i.e. disturbed thoughts and feelings about the infant and self-as-parent), maternal mentalisation (i.e. capacity to conceive of self and other's intentions in terms of mental states including thoughts, feelings, and desires), and quality of interaction in a clinical sample of mothers with Borderline Personality Disorder (BPD) features and their infants (N = 61). Measures used included the Childhood Trauma Questionnaire, Parent Development Interview, Mother-Infant Relationship Scale, Borderline Symptom Checklist-23, and the Emotional Availability Scales. The results indicated BPD features mediated the relationship between maternal trauma history and DMRs predicting disturbance in interaction. In addition, analyses showed that maternal mentalisation had a buffering effect between DMRs and maternal non-hostility and yet the severity of BPD features moderated the relationship between mentalisation and DMRs. The findings suggest postpartum borderline pathology may adversely impact the experience of being a parent for women with a relational trauma history including deficits in mentalisation (i.e. hypermentalising) and disturbances in the mother-infant interaction. Implications for research and clinical practice are discussed.
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Affiliation(s)
- Vesna Newman-Morris
- School of Psychological Sciences, Monash University, Monash, Victoria, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia.,Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Monash, Victoria, Australia
| | - Katrina Simpson
- School of Psychological Sciences, Monash University, Monash, Victoria, Australia
| | - Kylie M Gray
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, United Kingdom.,Drug and Alcohol Clinical Services, Hunter New England Local Health District, Sydney, New South Wales, Australia
| | - Natasha Perry
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Sydney, New South Wales, Australia.,School of Psychology, University of Newcastle, Sydney, New South Wales, Australia
| | - Adrian Dunlop
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Sydney, New South Wales, Australia.,Faculty of Health, University of Newcastle, Sydney, New South Wales, Australia
| | - Louise K Newman
- Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
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