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Maternal Mental Health and Infant Development During the COVID-19 Pandemic

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Importance  The COVID-19 pandemic has prompted an unprecedented need to rapidly investigate the potential consequences for maternal mental health, infant and child development, and the mother-infant relationship.

Observations  Globally, the mental health of pregnant and postpartum individuals has worsened during the pandemic regardless of infection status, and these concerning changes have disproportionally affected racial and ethnic minoritized people from underserved populations. Early indicators of infant neurobehavioral outcomes suggest that while in utero exposure to a maternal SARS-CoV-2 infection is likely negligible, limited data are available regarding the neurodevelopmental consequences for the generation of infants born during the pandemic. High maternal depression and grief during the COVID-19 pandemic are associated with lower levels of self-reported maternal-infant bonding. Yet nearly all published reports of child neurodevelopmental outcomes and dyadic functioning in the context of the pandemic rely on self-reported and parent-reported measures, which are subject to bias.

Conclusions and Relevance  In the context of prior research, and considering the paucity of research on infant neurodevelopment following prenatal SARS-CoV-2 exposure and birth during the pandemic, robust scientific investigation is needed to detect indicators of compromised early outcomes that could inform widespread assessment and accessible intervention. We simultaneously caution against reflexive apprehension regarding the generation of children born during the COVID-19 pandemic.

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Article Information

Accepted for Publication: July 11, 2022.

Published Online: August 31, 2022. doi:10.1001/jamapsychiatry.2022.2591

Corresponding Author: Catherine Monk, PhD, Columbia University Irving Medical Center, 622 W 168th St, PH15–1540H, New York, NY 10032 (cem31@cumc.columbia.edu).

Author Contributions: Dr Monk had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Dumitriu.

Drafting of the manuscript: Firestein, Dumitriu, Monk.

Critical revision of the manuscript for important intellectual content: Dumitriu, Marsh, Monk.

Obtained funding: Dumitriu, Marsh, Monk.

Supervision: Dumitriu, Monk.

Conflict of Interest Disclosures: Dr Dumitriu reported grants from the National Institute of Mental Health during the conduct of the study and consulting fees from Medela, funding from the Centers for Disease Control and Prevention, and personal fees from the Society for Neuroscience outside the submitted work. No other disclosures were reported.

Funding/Support: This work is supported by grants R01MH126531 and 301MH126531-01S1 from the National Institute of Mental Health (Drs Dumitriu, March, and Monk), Centers for Disease Control and Prevention contract 75D30120C08150 through Abt Associates (Dr Dumitriu), and an award from the Society for Research in Child Development (Dr Firestein).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We are grateful for the institutional support provided by the Maternal-Child Research Oversight (MaCRO) Committee and the Departments of Pediatrics, Psychiatry, and Obstetrics & Gynecology at Columbia University Irving Medical Center, as well as the entire COVID-19 Mother Baby Outcomes (COMBO) Initiative Team.

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