Abstract
The 1918 Influenza pandemic had long-term impacts on the cohort exposed inutero which experienced earlier adult mortality, and more diabetes, ischemic heart disease, and depression after age 50. It is possible that the Coronavirus Disease 2019 (COVID-19) pandemic will also have long-term impacts on the cohort that was inutero during the pandemic, from exposure to maternal infection and/or the stress of the pandemic environment. We discuss how COVID-19 disease during pregnancy may affect fetal and postnatal development with adverse impacts on health and aging. Severe maternal infections are associated with an exaggerated inflammatory response, thromboembolic events, and placental vascular malperfusion. We also discuss how inutero exposure to the stress of the pandemic, without maternal infection, may impact health and aging. Several recently initiated birth cohort studies are tracking neonatal health following inutero severe acute respiratory syndrome virus 2 (SARS-CoV-2) exposure. We suggest these cohort studies develop plans for longer-term observations of physical, behavioral, and cognitive functions that are markers for accelerated aging, as well as methods to disentangle the effects of maternal infection from stresses of the pandemic environment. In utero exposure to COVID-19 disease could cause developmental difficulties and accelerated aging in the century ahead. This brief review summarizes elements of the developmental origins of health, disease, and ageing and discusses how the COVID-19 pandemic might exacerbate such effects. We conclude with a call for research on the long-term consequences of inutero exposure to maternal infection with COVID-19 and stresses of the pandemic environment.
Highlights
By the end of 2020, about 300,000 infants may be born in the United States to mothers infected by the severe acute respiratory syndrome virus 2 (SARS-CoV-2) sometime during their pregnancy
Maternal COVID-19 infections and exposure to the pandemic environment may have long-term effects on growth and aging for the cohort in utero during this pandemic based on the 1918 influenza birth cohort
From comparisons of the 1918 Influenza with the current COVID-19 pandemic, we suggest studies of markers from birth through adulthood that are indicators of the altered development and accelerated aging that could be experienced in the century ahead
Summary
By the end of 2020, about 300,000 infants may be born in the United States to mothers infected by the severe acute respiratory syndrome virus 2 (SARS-CoV-2) sometime during their pregnancy. Postnatal effects of in utero exposure to SARS-CoV-2 from pregnant women with Coronavirus Disease 2019 (COVID-19) are mostly unknown, but are suggested from the 1918 Influenza pandemic which had lifelong effects on health and achievement. We suggest indicators of maternal, neonatal, and later life health that should be monitored following in utero exposure to SARS-CoV-2.
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