Maternal COVID-19 infection may lead to brain injury in fetal brain: Case report

USA: The study published in the
Journal of the American Academy of Pediatrics reported two cases of infants
born to mothers with COVID-19 who showed early-onset seizures, acquired
microcephaly, and significant developmental delay over time.

The COVID-19 pandemic has had a
profound effect on global health and has resulted in unfavorable maternal and
fetal outcomes. The study highlights the occurrence of severe neurological
damage in two infants: one a preterm baby born at 32-week gestational age and
the other a full-term baby born at 39-week gestational age. Notably, neither
infant tested positive for the SARS-CoV-2 virus through RT-PCR.

The two infants were born
without the virus but with detectable COVID-19 antibodies and increased blood
inflammatory markers, had severe parenchymal atrophy and cystic
encephalomalacia according to sequential MRI scans. Both infants suffered an ongoing
neurologic injury and developmental deficits, with one experiencing sudden
death at 13 months of age and extensive loss of brain white matter, gliosis,
and vacuolization at autopsy.

The placental pathology of both
mothers showed signs of SARS-CoV-2 infection, including the nucleocapsid
protein and spike glycoprotein 1 in the syncytiotrophoblast and fetal vascular
malperfusion, as well as increased inflammatory and oxidative stress markers.

The pre-term infant experienced
sudden unexpected death at 13 months of age. The deceased infant’s brain showed
evidence of SARS-CoV-2. The researchers concluded that second-trimester
maternal COVID-19 infection with placentitis triggered an inflammatory response
and oxidative stress injury to the fetoplacental unit that affected the fetal
brain. 

The study’s lead author Dr.
Merline Benny added that the findings highlight “The need for further research
on the potential long-term effects of COVID-19 on fetal brain development. The
researchers emphasized the importance of pregnant women getting vaccinated
against COVID-19 to prevent infection and protect the health of their unborn
babies.”

These findings also underline the importance of continuing to follow
COVID-19 safety measures such as wearing masks, social distancing, and avoiding
large gatherings, especially for pregnant women.

Reference:

Benny, M., Bandstra, E. S., Saad,
A. G., Lopez-Alberola, R., Saigal, G., Paidas, M. J., Jayakumar, A. R., &
Duara, S. (2023, April 6). Maternal SARS-CoV-2, Placental Changes and Brain
Injury in 2 Neonates. American Academy of Pediatrics.
https://doi.org/10.1542/peds.2022-058271