Pandemic beyond the virus: maternal COVID-related postnatal stress is associated with infant temperament

Abstract

Background Studies have shown that infant temperament varies with maternal psychosocial factors, in utero illness, and environmental stressors. We predicted that the pandemic would shape infant temperament through maternal SARS-CoV-2 infection during pregnancy and/or maternal postnatal stress. To test this, we examined associations among infant temperament, maternal prenatal SARS-CoV-2 infection, maternal postnatal stress, and postnatal COVID-related life disruptions. Methods We tested 63 mother–infant dyads with prenatal maternal SARS-CoV-2 infections and a comparable group of 110 dyads without infections. To assess postnatal maternal stress, mothers completed the Perceived Stress Scale 4 months postpartum and an evaluation of COVID-related stress and life disruptions 6 months postpartum. Mothers reported on infant temperament when infants were 6-months-old using the Infant Behavior Questionnaire-Revised (IBQ-R) Very Short Form. Results Maternal SARS-CoV-2 infection during pregnancy was not associated with infant temperament or maternal postnatal stress. Mothers with higher self-reported postnatal stress rated their infants lower on the Positive Affectivity/Surgency and Orienting/Regulation IBQ-R subscales. Mothers who reported greater COVID-related life disruptions rated their infants higher on the Negative Emotionality IBQ-R subscale. Conclusions Despite no effect of prenatal maternal SARS-CoV-2 infection, stress and life disruptions incurred by the COVID-19 pandemic were associated with infant temperament at 6-months. Impact SARS-CoV-2 infection during pregnancy is not associated with postnatal ratings of COVID-related life disruptions, maternal stress, or infant temperament. Postnatal ratings of maternal stress during the COVID-19 pandemic are associated with normative variation in maternal report of infant temperament at 6 months of age. Higher postnatal ratings of maternal stress are associated with lower scores on infant Positive Affectivity/Surgency and Orienting/Regulation at 6 months of age. Higher postnatal ratings of COVID-related life disruptions are associated with higher scores on infant Negative Emotionality at 6 months of age.

Impact of COVID-19 related maternal stress on fetal brain development: A Multimodal MRI study

“…Our findings of altered brain connectivity agree with previous findings of altered brain connectivity in infants of mothers who reported higher stress during the pandemic[15]. Behavioral and functional deficits particularly in the motor, cognitive and temperamental domain have been widely reported in various studies investigating the impact of maternal stress during the pandemic on child outcomes [7,8,13,14]. Increased maternal stress and anxiety traits (outside the setting of the pandemic) have been shown to alter functional architecture of the fetal brain[47].…”

“…Studies of infants born during the COVID-19 pandemic have reported reduced cognitive, motor, and emotional development compared to those born pre-pandemic [7,8], with increased prenatal stress directly associated with adverse effect and temperament [13,14]. Simultaneously, changes to brain structure and function have also been reported in infants born during the pandemic [15].…”

“…Unsurprisingly, pregnant women indicated elevated levels of stress during the COVID-19 pandemic [6]. In addition to health consequences for the mother, increased maternal stress has an intergenerational impact on fetal development [7,8]. Increased maternal stress during pregnancy is known to alter the fetal brain and adversely impact postnatal neurodevelopmental outcomes [9][10][11][12].…”

Mediators of inflammation at the maternal‐fetal interface are altered by SARS‐CoV‐2 infection and pandemic stress

“…It is known that stress during pregnancy can influence placental health and long‐term child development 4,16–20 . In terms of the COVID‐19 pandemic, the vast majority of the work has been focused on the impact of the infection, without taking into consideration the potential immune contribution of pandemic‐associated stress.…”

“…15 It is known that stress during pregnancy can influence placental health and long-term child development. 4,[16][17][18][19][20] In terms of the COVID-19 pandemic, the vast majority of the work has been focused on the impact of the infection, without taking into consideration the potential immune contribution of pandemic-associated stress. Of interest, Shuffrey et al investigated neurodevelopment at 6 months of age following maternal SARS-CoV-2 infection during pregnancy and observed differences regardless of infection status, which emphasise the role that pandemic stress has on fetal health.…”