Skip to main content
SpringerLink
Log in

Collateral Damage of the COVID-19 Pandemic for the Next Generation: A Call to Action

  • Chapter
  • First Online:
COVID-19 and Perinatology

  • 97 Accesses

Abstract

The COVID-19 pandemic had a major psychological impact on society, particularly affecting its vulnerable members including pregnant women and their (un)born children. Moreover, accumulating evidence indicates that maternal stress can have lifelong effects on the unborn child. Accordingly, pregnant women’s vulnerability for mental health problems has become a concern during the COVID-19 pandemic. This chapter highlights the psychological impact of the COVID-19 pandemic on pregnant women and the potential short- and long-term consequences for their offspring. An overview is provided of the effects of prenatal maternal stress caused by previous disasters. Moreover, potential mechanisms are discussed of fetal programming and transgenerational effects of maternal prenatal stress. We conclude that the lessons learned from experiences with previous disasters should quickly be applied to the current COVID-19 pandemic. Close monitoring of offspring after prenatal stress due to the COVID-19 pandemic is necessary to detect and effectively target vulnerable developmental windows and divert adverse outcomes later during the life course.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Been JV, et al. Impact of COVID-19 mitigation measures on the incidence of preterm birth: a national quasi-experimental study. Lancet Public Health. 2020;5:e604–11. https://doi.org/10.1016/S2468-2667(20)30223-1.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Son JY, et al. Reductions in mortality resulting from reduced air pollution levels due to COVID-19 mitigation measures. Sci Total Environ. 2020;744:141012. https://doi.org/10.1016/j.scitotenv.2020.141012.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Van den Bergh BRH, et al. Prenatal developmental origins of behavior and mental health: the influence of maternal stress in pregnancy. Neurosci Biobehav Rev. 2020;117:26–64. https://doi.org/10.1016/j.neubiorev.2017.07.003.

    Article  PubMed  Google Scholar 

  4. Browne PD, Bossenbroek R, Kluft A, van Tetering EMA, de Weerth C. Prenatal anxiety and depression: treatment uptake, barriers, and facilitators in midwifery care. J Womens Health (Larchmt). 2021;30:1116–26. https://doi.org/10.1089/jwh.2019.8198.

    Article  PubMed  Google Scholar 

  5. Missler M, van Straten A, Denissen J, Donker T, Beijers R. Effectiveness of a psycho-educational intervention for expecting parents to prevent postpartum parenting stress, depression and anxiety: a randomized controlled trial. BMC Pregnancy Childbirth. 2020;20:658. https://doi.org/10.1186/s12884-020-03341-9.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Barzilay R, et al. Resilience, COVID-19-related stress, anxiety and depression during the pandemic in a large population enriched for healthcare providers. Transl Psychiatry. 2020;10:291. https://doi.org/10.1038/s41398-020-00982-4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Ghazanfarpour M, et al. Prevalence of anxiety and depression among pregnant women during the COVID-19 pandemic: a meta-analysis. J Psychosom Obstet Gynaecol. 2021;43:315–26. https://doi.org/10.1080/0167482X.2021.1929162.

    Article  PubMed  Google Scholar 

  8. Vacaru S, et al. The risk and protective factors of heightened prenatal anxiety and depression during the COVID-19 lockdown. Sci Rep. 2021;11:20261. https://doi.org/10.1038/s41598-021-99662-6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Kwong ASF, et al. Mental health before and during the COVID-19 pandemic in two longitudinal UK population cohorts. Br J Psychiatry. 2021;218:334–43. https://doi.org/10.1192/bjp.2020.242.

    Article  CAS  PubMed  Google Scholar 

  10. Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. J Affect Disord. 2020;277:5–13. https://doi.org/10.1016/j.jad.2020.07.126.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Saccone G, et al. Psychological impact of coronavirus disease 2019 in pregnant women. Am J Obstet Gynecol. 2020;223:293–5. https://doi.org/10.1016/j.ajog.2020.05.003.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Covid-19 and pregnancy. 2020;369:m1672. https://doi.org/10.1136/bmj.m1672.

  13. Assiri AM, et al. Epidemiology of a novel recombinant Middle East respiratory syndrome coronavirus in humans in Saudi Arabia. J Infect Dis. 2016;214:712–21. https://doi.org/10.1093/infdis/jiw236.

    Article  PubMed  Google Scholar 

  14. Wong SF, Chow KM, de Swiet M. Severe acute respiratory syndrome and pregnancy. BJOG. 2003;110:641–2. https://doi.org/10.1046/j.1471-0528.2003.03008.x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Verweij EJ, M'Hamdi HI, Steegers EAP, Reiss IKM, Schoenmakers S. Collateral damage of the covid-19 pandemic: a Dutch perinatal perspective. BMJ. 2020;369:m2326. https://doi.org/10.1136/bmj.m2326.

    Article  PubMed  Google Scholar 

  16. Ettman CK, et al. Prevalence of depression symptoms in US adults before and during the COVID-19 pandemic. JAMA Netw Open. 2020;3:e2019686. https://doi.org/10.1001/jamanetworkopen.2020.19686.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Josephson A, Kilic T, Michler JD. Socioeconomic impacts of COVID-19 in low-income countries. Nat Hum Behav. 2021;5:557. https://doi.org/10.1038/s41562-021-01096-7.

    Article  PubMed  Google Scholar 

  18. Wilke J, et al. Drastic reductions in mental well-being observed globally during the COVID-19 pandemic: results from the ASAP survey. Front Med (Lausanne). 2021;8:578959. https://doi.org/10.3389/fmed.2021.578959.

    Article  PubMed  Google Scholar 

  19. Boserup B, McKenney M, Elkbuli A. Alarming trends in US domestic violence during the COVID-19 pandemic. Am J Emerg Med. 2020;38:2753–5. https://doi.org/10.1016/j.ajem.2020.04.077.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Kwong ASF, et al. Mental health before and during the COVID-19 pandemic in two longitudinal UK population cohorts. Br J Psychiatry. 2020;218:334–43. https://doi.org/10.1192/bjp.2020.242.

    Article  CAS  Google Scholar 

  21. Roberton T, et al. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Health. 2020;8:e901–8. https://doi.org/10.1016/S2214-109X(20)30229-1.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Abrams EM, Szefler SJ. COVID-19 and the impact of social determinants of health. Lancet Respir Med. 2020;8:659–61. https://doi.org/10.1016/S2213-2600(20)30234-4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA. 2020;24:782–93. https://doi.org/10.1001/jama.2020.12839.

    Article  CAS  Google Scholar 

  24. Husen MF, et al. Unique severe COVID-19 placental signature independent of severity of clinical maternal symptoms. Viruses. 2021;13:1670. https://doi.org/10.3390/v13081670.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. DeSisto CL, et al. Risk for stillbirth among women with and without COVID-19 at delivery hospitalization - United States, march 2020-September 2021. MMWR Morb Mortal Wkly Rep. 2021;70:1640–5. https://doi.org/10.15585/mmwr.mm7047e1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Schwartz DA, et al. Placental tissue destruction and insufficiency from COVID-19 causes stillbirth and neonatal death from hypoxic-ischemic injury: a study of 68 cases with SARS-CoV-2 placentitis from 12 countries. Arch Pathol Lab Med. 2022;146:660. https://doi.org/10.5858/arpa.2022-0029-SA.

    Article  CAS  PubMed  Google Scholar 

  27. Goncu Ayhan S, et al. COVID-19 vaccine acceptance in pregnant women. Int J Gynaecol Obstet. 2021;154:291–6. https://doi.org/10.1002/ijgo.13713.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Riad A, et al. COVID-19 vaccine acceptance of pregnant and lactating women (PLW) in Czechia: an analytical cross-sectional study. Int J Environ Res Public Health. 2021;18:13373. https://doi.org/10.3390/ijerph182413373.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Skjefte M, et al. COVID-19 vaccine acceptance among pregnant women and mothers of young children: results of a survey in 16 countries. Eur J Epidemiol. 2021;36:197–211. https://doi.org/10.1007/s10654-021-00728-6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Wilson RJ, Paterson P, Jarrett C, Larson HJ. Understanding factors influencing vaccination acceptance during pregnancy globally: a literature review. Vaccine. 2015;33:6420–9. https://doi.org/10.1016/j.vaccine.2015.08.046.

    Article  PubMed  Google Scholar 

  31. Van Spall HGC. Exclusion of pregnant and lactating women from COVID-19 vaccine trials: a missed opportunity. Eur Heart J. 2021;42:2724–6. https://doi.org/10.1093/eurheartj/ehab103.

    Article  CAS  PubMed  Google Scholar 

  32. Madigan S, et al. A meta-analysis of maternal prenatal depression and anxiety on child socioemotional development. J Am Acad Child Adolesc Psychiatry. 2018;57:645–657.e8. https://doi.org/10.1016/j.jaac.2018.06.012.

    Article  PubMed  Google Scholar 

  33. Manzari N, Matvienko-Sikar K, Baldoni F, O'Keeffe GW, Khashan AS. Prenatal maternal stress and risk of neurodevelopmental disorders in the offspring: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol. 2019;54:1299–309. https://doi.org/10.1007/s00127-019-01745-3.

    Article  PubMed  Google Scholar 

  34. Beijers R, Buitelaar JK, de Weerth C. Mechanisms underlying the effects of prenatal psychosocial stress on child outcomes: beyond the HPA axis. Eur Child Adolesc Psychiatry. 2014;23:943–56. https://doi.org/10.1007/s00787-014-0566-3.

    Article  PubMed  Google Scholar 

  35. Barker DJ. The developmental origins of adult disease. Eur J Epidemiol. 2003;18:733–6. https://doi.org/10.1023/a:1025388901248.

    Article  CAS  PubMed  Google Scholar 

  36. Barker DJ. The origins of the developmental origins theory. J Intern Med. 2007;261:412–7. https://doi.org/10.1111/j.1365-2796.2007.01809.x.

    Article  CAS  PubMed  Google Scholar 

  37. Barouki R, Gluckman PD, Grandjean P, Hanson M, Heindel JJ. Developmental origins of non-communicable disease: implications for research and public health. Environ Health. 2012;11:42. https://doi.org/10.1186/1476-069X-11-42.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Schoenmakers S, et al. The impact of maternal prenatal stress related to the COVID-19 pandemic during the first 1000 days: a historical perspective. Int J Environ Res Public Health. 2022;19:4710. https://doi.org/10.3390/ijerph19084710.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Reduction UNOfDR. Available online: https://www.unisdr.org/files/7817_UNISDRTerminologyEnglish.pdf. (accessed on 21 April 2023).

  40. Yehuda R, et al. Transgenerational effects of posttraumatic stress disorder in babies of mothers exposed to the World Trade Center attacks during pregnancy. J Clin Endocrinol Metab. 2005;90:4115–8. https://doi.org/10.1210/jc.2005-0550.

    Article  CAS  PubMed  Google Scholar 

  41. Shapiro GD, Fraser WD, Frasch MG, Seguin JR. Psychosocial stress in pregnancy and preterm birth: associations and mechanisms. J Perinat Med. 2013;41:631–45. https://doi.org/10.1515/jpm-2012-0295.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Entringer S, et al. Influence of prenatal psychosocial stress on cytokine production in adult women. Dev Psychobiol. 2008;50:579–87. https://doi.org/10.1002/dev.20316.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Ballard PL, Ballard RA. Scientific basis and therapeutic regimens for use of antenatal glucocorticoids. Am J Obstet Gynecol. 1995;173:254–62. https://doi.org/10.1016/0002-9378(95)90210-4.

    Article  CAS  PubMed  Google Scholar 

  44. Hey E. Neonatal formulary: drug use in pregnancy and the first year of life. Wiley; 2011.

    Book  Google Scholar 

  45. Ninan K, Liyanage SK, Murphy KE, Asztalos EV, McDonald SD. Evaluation of long-term outcomes associated with preterm exposure to antenatal corticosteroids: a systematic review and meta-analysis. JAMA Pediatr. 2022;176:e220483. https://doi.org/10.1001/jamapediatrics.2022.0483.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Zijlmans MA, Riksen-Walraven JM, de Weerth C. Associations between maternal prenatal cortisol concentrations and child outcomes: A systematic review. Neurosci Biobehav Rev. 2015;53:1–24. https://doi.org/10.1016/j.neubiorev.2015.02.015.

    Article  CAS  PubMed  Google Scholar 

  47. Cook CJ, Fletcher JM, Forgues A. Multigenerational effects of early-life health shocks. Demography. 2019;56:1855–74. https://doi.org/10.1007/s13524-019-00804-3.

    Article  PubMed  Google Scholar 

  48. Helgertz J, Bengtsson T. The long-lasting influenza: the impact of fetal stress during the 1918 influenza pandemic on socioeconomic attainment and health in Sweden, 1968-2012. Demography. 2019;56:1389–425. https://doi.org/10.1007/s13524-019-00799-x.

    Article  PubMed  Google Scholar 

  49. Lin MJ, Liu EM. Does in utero exposure to illness matter? The 1918 influenza epidemic in Taiwan as a natural experiment. J Health Econ. 2014;37:152–63. https://doi.org/10.1016/j.jhealeco.2014.05.004.

    Article  PubMed  Google Scholar 

  50. Mazumder B, Almond D, Park K, Crimmins EM, Finch CE. Lingering prenatal effects of the 1918 influenza pandemic on cardiovascular disease. J Dev Orig Health Dis. 2010;1:26–34. https://doi.org/10.1017/S2040174409990031.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Kyle UG, Pichard C. The Dutch Famine of 1944-1945: a pathophysiological model of long-term consequences of wasting disease. Curr Opin Clin Nutr Metab Care. 2006;9:388–94. https://doi.org/10.1097/01.mco.0000232898.74415.42.

    Article  PubMed  Google Scholar 

  52. Painter RC, Roseboom TJ, Bleker OP. Prenatal exposure to the Dutch famine and disease in later life: an overview. Reprod Toxicol. 2005;20:345–52. https://doi.org/10.1016/j.reprotox.2005.04.005.

    Article  CAS  PubMed  Google Scholar 

  53. Neugebauer R, Hoek HW, Susser E. Prenatal exposure to wartime famine and development of antisocial personality disorder in early adulthood. JAMA. 1999;282:455–62. https://doi.org/10.1001/jama.282.5.455.

    Article  CAS  PubMed  Google Scholar 

  54. Susser E, et al. Schizophrenia after prenatal famine. Further evidence. Arch Gen Psychiatry. 1996;53:25–31. https://doi.org/10.1001/archpsyc.1996.01830010027005.

    Article  CAS  PubMed  Google Scholar 

  55. Susser ES, Lin SP. Schizophrenia after prenatal exposure to the Dutch Hunger Winter of 1944-1945. Arch Gen Psychiatry. 1992;49:983–8. https://doi.org/10.1001/archpsyc.1992.01820120071010.

    Article  CAS  PubMed  Google Scholar 

  56. Ji C, et al. Prenatal earthquake exposure and midlife uric acid levels among Chinese adults. Arthritis Care Res (Hoboken). 2017;69:703–8. https://doi.org/10.1002/acr.22973.

    Article  CAS  PubMed  Google Scholar 

  57. King S, Laplante DP. The effects of prenatal maternal stress on children’s cognitive development: project ice storm. Stress. 2005;8:35–45. https://doi.org/10.1080/10253890500108391.

    Article  PubMed  Google Scholar 

  58. Cao-Lei L, et al. DNA methylation mediates the impact of exposure to prenatal maternal stress on BMI and central adiposity in children at age 13(1/2) years: project ice storm. Epigenetics. 2015;10:749–61. https://doi.org/10.1080/15592294.2015.1063771.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Liu GT, Dancause KN, Elgbeili G, Laplante DP, King S. Disaster-related prenatal maternal stress explains increasing amounts of variance in body composition through childhood and adolescence: project ice storm. Environ Res. 2016;150:1–7. https://doi.org/10.1016/j.envres.2016.04.039.

    Article  CAS  PubMed  Google Scholar 

  60. St-Pierre J, et al. Natural disaster-related prenatal maternal stress is associated with alterations in placental glucocorticoid system: the QF2011 Queensland flood study. Psychoneuroendocrinology. 2018;94:38–48. https://doi.org/10.1016/j.psyneuen.2018.04.027.

    Article  CAS  PubMed  Google Scholar 

  61. McLean MA, Cobham VE, Simcock G, Kildea S, King S. Toddler temperament mediates the effect of prenatal maternal stress on childhood anxiety symptomatology: the QF2011 Queensland flood study. Int J Environ Res Public Health. 2019;16:1998. https://doi.org/10.3390/ijerph16111998.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Nomura Y, et al. Influence of in utero exposure to maternal depression and natural disaster-related stress on infant temperament at 6 months: the children of superstorm Sandy. Infant Ment Health J. 2019;40:204–16. https://doi.org/10.1002/imhj.21766.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Zhang W, et al. Prenatal exposure to disaster-related traumatic stress and developmental trajectories of temperament in early childhood: superstorm Sandy pregnancy study. J Affect Disord. 2018;234:335–45. https://doi.org/10.1016/j.jad.2018.02.067.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Mrejen M, Perelman J, Machado DC. Environmental disasters and birth outcomes: impact of a tailings dam breakage in Brazil. Soc Sci Med. 2020;250:112868. https://doi.org/10.1016/j.socscimed.2020.112868.

    Article  PubMed  Google Scholar 

  65. Richter J, et al. Effects of an early intervention on perceived stress and diurnal cortisol in pregnant women with elevated stress, anxiety, and depressive symptomatology. J Psychosom Obstet Gynaecol. 2012;33:162–70. https://doi.org/10.3109/0167482X.2012.729111.

    Article  PubMed  Google Scholar 

  66. Zarenejad M, Yazdkhasti M, Rahimzadeh M, Mehdizadeh Tourzani Z, Esmaelzadeh-Saeieh S. The effect of mindfulness-based stress reduction on maternal anxiety and self-efficacy: a randomized controlled trial. Brain Behav. 2020;10:e01561. https://doi.org/10.1002/brb3.1561.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Thomas M, et al. Potential for a stress reduction intervention to promote healthy gestational weight gain: focus groups with low-income pregnant women. Womens Health Issues. 2014;24:e305–11. https://doi.org/10.1016/j.whi.2014.02.004.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Missler M, et al. Universal prevention of distress aimed at pregnant women: a systematic review and meta-analysis of psychological interventions. BMC Pregnancy Childbirth. 2021;21:276. https://doi.org/10.1186/s12884-021-03752-2.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands

    Sam Schoenmakers

  2. Social Development, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands

    Roseriet Beijers

  3. Cognitive Neuroscience, Donders Institute, Radboud University Medical Center, Nijmegen, The Netherlands

    Roseriet Beijers

  4. Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands

    E. J. (Joanne) Verweij

Authors
  1. Sam Schoenmakers
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roseriet Beijers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. J. (Joanne) Verweij
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sam Schoenmakers .

Editor information

Editors and Affiliations

  1. Neonatology Department, APHP-University of Paris-Saclay, Le Kremlin-Bicêtre, France

    Daniele De Luca

  2. Obstetrics and Gynecology Department, APHP-University of Paris-Saclay, Le Kremlin-Bicêtre, France

    Alexandra Benachi

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Schoenmakers, S., Beijers, R., Verweij, E.J.(. (2023). Collateral Damage of the COVID-19 Pandemic for the Next Generation: A Call to Action. In: De Luca, D., Benachi, A. (eds) COVID-19 and Perinatology . Springer, Cham. https://doi.org/10.1007/978-3-031-29136-4_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-29136-4_18

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-29135-7

  • Online ISBN: 978-3-031-29136-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation