Though Covid-19 infections are on the decline, the world continues to grapple with the pandemic’s unexpected long-term implications. Of particular interest has been the developmental outcomes for children of women who contracted Covid-19 while pregnant. In a recent study published in JAMA Pediatrics, data suggest that heightened maternal stress during the pandemic – not foetal exposure to SARS-CoV-2 – has contributed to underperforming psychosocial development indicators.

Historical data suggests that some coronaviruses have induced neurodevelopmental complications in children or infected mothers. Mothers with Middle East Respiratory Syndrome (MERS) and severe acute respiratory syndrome (SARS) infections could experience immune responses associated with developmental complications in their babies. Across the sixteen major pharmaceutical markets (16MM: the US, France, Germany, Italy, Spain, UK, Japan, China, Australia, Brazil, Canada, India, Mexico, Russia, South Africa and South Korea), GlobalData epidemiologists expect that the results of this study may indicate a rise in behavioural disorders among children in the coming years.

In the first study to analyse Covid-19’s influence on neural development, Columbia University launched a cohort study in 2020 that tracked health outcomes for pregnant mothers and their children in New York City. Among the study’s 255 participating infants, roughly half were exposed to Covid-19 during foetal development. At six months of age, their children’s behavioural, social and cognitive abilities were evaluated based on the Ages and Stages Questionnaire (ASQ-3). Surprisingly, there was no statistically significant difference in scores of the tests taken by either cohort.

The data drew a strong distinction, however, between the scores of pre and post-pandemic infants. Results of Covid-19 era participants were compared with historical test scores. Children of women who entered their first trimester during the pandemic exhibited statistically significantly lower mean scores on gross motor, fine motor and personal-social tests than pre-pandemic infants (as shown in Figure 1). Furthermore, scores were lowest among children whose mothers were in their first trimester during the time of peak Covid-19 infections.

To account for these performance discrepancies, the study organisers considered the socioeconomic and emotional toll experienced by pregnant women in the early months of the pandemic. Mothers reported high rates of housing, job and food insecurity, as well as high depression and anxiety rates during this time. The study proposes that the economic turmoil and sense of loneliness brought on increased stress among women in early pregnancy, raising the risk of neurodevelopmental complications during gestation.

The neurodevelopmental consequences of Covid-19 have yet to be fully determined, but they will likely lead to a rise in the prevalence of various cognitive and behavioural disorders. In the 16MM, GlobalData epidemiologists forecast that diagnosed prevalent cases of ADHD will increase from around 119 million in 2022 to more than 122 million in 2024, driven primarily by changes in the underlying population. But the pandemic’s influence on babies’ cognitive and social development will likely disrupt these initial projections by expediting their rates of growth to surpass current forecast estimates. Ideally, parents, schools and policymakers will intervene to accommodate for this dire outlook. Any measures will, however, likely require a more complete understanding of Covid-19’s influence on fetal and childhood development.

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