Maternal infections during pregnancy and child cognitive outcomes

Abstract

Background Maternal prenatal infections have been linked to children’s neurodevelopment and cognitive outcomes. It remains unclear, however, whether infections occurring during specific vulnerable gestational periods can affect children’s cognitive outcomes. The study aimed to examine maternal infections in each trimester of pregnancy and associations with children’s developmental and intelligence quotients. The ALSPAC birth cohort was used to investigate associations between maternal infections in pregnancy and child cognitive outcomes. Methods Infection data from mothers and cognition data from children were included with the final study sample size comprising 7,410 mother-child participants. Regression analysis was used to examine links between maternal infections occurring at each trimester of pregnancy and children’s cognition at 18 months, 4 years, and 8 years. Results Infections in the third trimester were significantly associated with decreased verbal IQ at age 4 (p < .05, adjusted R2 = 0.004); decreased verbal IQ (p < .01, adjusted R2 = 0.001), performance IQ (p < .01, adjusted R2 = 0.0008), and total IQ at age 8 (p < .01, adjusted R2 = 0.001). Conclusion Results suggest that maternal infections in the third trimester could have a latent effect on cognitive development, only emerging when cognitive load increases over time, though magnitude of effect appears to be small. Performance IQ may be more vulnerable to trimester-specific exposure to maternal infection as compared to verbal IQ. Future research could include examining potential mediating mechanisms on childhood cognition, such as possible moderating effects of early childhood environmental factors, and if effects persist in future cognitive outcomes.

Investigating low birthweight and preterm birth as potential mediators in the relationship between prenatal infections and early child development: A linked administrative health data analysis

“…This has been shown in animal models [12-14], and human studies are broadly consistent with this [15]. Consequently, MIA tends to be cited as the most likely reason for associations observed between prenatal maternal infections and childhood developmental outcomes in existing research [1-3, 5].…”

“…Maternal health during pregnancy plays an important role in shaping later childhood development, and there is now a growing body of evidence suggesting that prenatal maternal infections are associated with early childhood developmental outcomes. Previous research has found associations between maternal infections during pregnancy and reduced cognitive abilities [1, 2], emotional difficulties [3], health visitor developmental concerns [4] and a range of other developmental vulnerabilities [5] in children. There is also a large body of evidence linking prenatal maternal infections to childhood diagnoses of neurodevelopmental conditions such as autism [6-8] and attention-deficit/hyperactivity-disorder (ADHD) [9], as well as to adulthood mental health conditions including schizophrenia [10] and bipolar disorder [11].…”

Prenatal maternal infections and early childhood developmental outcomes: Analysis of linked administrative health data for Greater Glasgow & Clyde, Scotland

“…In addition to the above primary explanatory variables, two further sets of explanatory variables were used in order to examine whether any potential associations between prenatal infections and childhood developmental outcomes varied depending on the trimester in which infections occurred. This is important to consider because fetal brain myelination does not begin until the second trimester of pregnancy (with further growth reinforcements occuring in trimester 3, see Cordeiro et al ., 2015; Kwok et al ., 2022). To measure this, the hospital-diagnosed prenatal infection(s) measure was disaggregated into: (a) hospital-diagnosed prenatal infection(s) in trimester 1, (b) hospital-diagnosed prenatal infection(s) in trimester 2, and (c) hospital-diagnosed prenatal infection(s) in trimester 3.…”

“…There are, however, some important limitations to these existing pieces of research. Notably, they have tended to use data on prenatal infections that are either: (a) self-reported, and thus limited by issues relating to a lack of a strong verification that infections were present and by the retrospective nature of reporting (see Hall et al ., 2021; Kwok et al ., 2022), or (b) based on hospital records only, and thus limited by only including a minority of infections that are most severe (Green et al ., 2018). The present study overcomes some of these limitations by making use of prenatal infections data from both hospital records and infection-related prescriptions.…”

“…However, other research, conducted by Hall et al (2021) using data from a UK cohort study, found no association between hospital-recorded prenatal infections and childhood socioemotional developmental outcomes at age 3, but did find self-reported maternal infections to be associated with increased emotional problems. Finally, research by Kwok et al (2022), which examined maternal infections in each trimester of pregnancy and associations with child cognitive outcomes, suggests that infections in the third trimester could have an effect on cognitive abilities later in childhood (although effect sizes were small).…”