Medical Technology

COVID in Pregnancy Doesn’t Harm Fetal Brain Structure

Editor’s note: Find the latest COVID-19 news and instructions in Medscape’s Coronavirus Resource Center.

According to a study of a limited size, mild to moderate COVID-19 during pregnancy doesn’t appear to affect the development of the brain in the foetus.

Dr Sergio Grosu

Sergio Grosu MD, a radiologist at University Hospital in Munich, Germany presented his results on Wednesday at the Radiological Society of North America’s (RSNA) 2021 Annual meeting.

Evidence has previously shown that pregnant women are more vulnerable to the SARS-CoV-2 virus but little is known about any implications for the fetus.

Dr Sophia Stocklein

Sophia Stocklein (MD), an author of the lead paper at the Department of Radiology of Ludwig Maximilian University of Munich, Germany, said Medscape Medical News that the findings of fetal MRI should be reassuring to pregnant women and their partners who currently or recently became infected.

“From other viral infections, such as Zika virus infection or CMV [cytomegalovirus] infections, we know that impairment of the brain’s development in the prenatal period can be extensive,” she said. “SARS-CoV-2 is not believed to have the same immediate effects,” Stocklein said.

33 pregnant women were taken part in the study. All 33 patients who contracted SARS-CoV-2 during pregnancy were included in the study. They all had normal brain development, including cortical folds and brainstem segmentation.

Two board-certified radiologists who were experienced in fetal MRI examined the surface of the brain and the fluid-filled spaces and examined for signs of brain calcifications and swelling and found no abnormalities. They discovered that the size of all brain stem structures throughout all fetuses was adequate for the age of the fetus.

Grosu said that 22 of 33 babies have been born and that brain development has been normal to this point.

He noted that the mean gestational time in the study was 28.4 week. The average gestational age at the time of the mother’s first onset of symptoms was 18 weeks.

Grosu said that the team will continue to study and will monitor all infants until they reach the age of 5.

Dr Kathryn Gray

Asked for independent comment, Kathryn J. Gray, MD, PhD, an attending doctor in fetal and maternal medicine at Brigham and Women’s Hospital, Boston, Massachusetts, said Medscape Medical Newsit is important to note that the women included in the study had mild or moderate disease. This limitation was acknowledged by the authors.

Stocklein stated that the mild to moderate cases were examined because with severe cases it could be difficult to separate direct effects of the virus from the indirect effects of ventilation and vasopressor therapy, as an example.

Gray said, “While it is reassuring that everything is looking good We would also expect that. According to data, vertical transmission is extremely rare.

She also noted that fetal MRIs illuminate the structure of the brain but don’t provide a reliable prediction of the long-term function of the brain.

She said, “That is a more alarming aspect that requires ongoing monitoring, and I am aware that a number of groups are specifically focused upon studying this as well, so it will take time for us to understand.”

The immediate need is constant attention to how COVID-19 impacts the mother, she said. Women with COVID that is severe tend to deliver earlier and also have higher blood pressure, and are more likely to suffer hemorhage at birth.

“Complications of the pregnancy are both bad for the mother as well as for the baby,” she noted.

The Centers for Disease Control and Prevention suggests that pregnant women get vaccinated. However, the rate of vaccination has been slow.

The CDC states that people with COVID-19 during pregnancy are at a higher risk of stillbirth and preterm birth (pregnancy that occurs prior to 37 weeks).

“If you are pregnant or were recently pregnant, you are more likely to suffer from severe illness due to COVID-19 as compared to those who aren’t pregnant.” the CDC website provides a detailed explanation.

Grosu discloses a Koninklijke Philips NV research grant. Stocklein and Gray have not disclosed any relevant financial relationships.

Radiological Society of North America (RSNA) 2021 Annual Meeting Session SSRI02-3. Presented December 1, 2021.

Marcia Frellick, a Chicago-based freelance journalist, is Marcia Frellick. Follow her on Twitter at @mfrellick.

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