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Neurodevelopmental risk assessment in the COVID-19 Mother Baby Outcomes (COMBO) Initiative at Columbia University

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Abstract: Fetal exposure to perturbation of the intrauterine environment is implicated in altered brain development and longterm offspring vulnerability for neurodevelopmental and psychiatric sequalae. Globally, around 300 million infants have been born since the onset of the COVID -19 pandemic, with a substantive proportion exposed to maternal SARS -CoV-2 infection during pregnancy. Therefore, there have been global calls to action urging the evaluation of the neurodevelopment of infants born during this crisis. Efforts focus on assessing two hypothesized pathways: direct effects mediated through viral infection (either via vertical transmission or via maternal immune activation) or indirect effects mediated through maternal stress during pregnancy. In this talk, I will detail our efforts to uncover the independent and/or interactive effects of these two mechanisms on infant neurodevelopment in our COVID -19 Mother Baby Outcomes (COMBO) Initiative (www.ps.columbia.edu/COMBO), spearheaded at Columbia University in New York City in the spring of 2020. To date, our data shows subtle but significant effects on the neurodevelopment of infants born during the pandemic do exist, and that these effects are more likely to be attributable to maternal stress. In a recent published report (Shuffrey et al, JAMA Pediatrics, 2022), we showed no differences exist in the neurodevelopmental scores of 6 month old infants with and without fetal exposure to maternal SARS -CoV-2 infection as measured by maternal report on the Ages and Stages Questionnaire 3rd Ed (ASQ-3), but the combined pandemic-born cohort has slightly lower scores on motor and social skills compared to a cohort born at the same institution in the preceding 3 years prior to the pandemic. I will also present unpublished follow up data supporting the lack of an effect of maternal viral infection in a novel observational assessment conducted via Zoom at 6-12 months of age, as well as data showing that as the pandemic progresses, there is a promising normalization of the initial effects observed in infants that were in utero during the first wave in the spring of 2020.

Bio:

Dani Dumitriu, MD, PhD, is a pediatrician and neuroscientist at Columbia University Irving Medical Center. She completed her physician-scientist training, pediatric residency, and a pediatric environmental health fellowship at the Icahn School of Medicine at Mount Sinai and was the first female to secure R01 -level independent funding from the NIH during clinical training. She currently spends 20% time as a hospitalist in the Well Baby Nursery and 80% time conducting research into the mechanism of emotional connection and resilience across species and investigational scales in her dual roles as Principal Investigator of the Developmental Origins of Resilience (DOOR) lab and as the newly appointed Director of the Nurture Science Program. Her most recent research focus has been to investigate the role of the COVID -19 pandemic on the generation born during these uncertain and changing times, and she is the founder and Chair of Columbia University’s COVID -19 Mother Baby Outcomes (COMBO) Initiative.

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