1/5 The Cumulative Risk of Substance Exposure and Early Life Adversity on Child Health Development and Outcomes

PROJECT SUMMARY / DESCRIPTIONDoes maternal infection by the SARS-CoV-2 virus during pregnancy harm the developing fetal brain or increasethe sensitivity to later developmental and environmental insults? he novel coronavirus (Covid-19) outbreak hasfundamentally altered the child health landscape, ushering in sweeping changes in the social and economicfabric within which children grow. The rapidity of these environment changes, coupled with the relatively noveltyof the SARS-CoV-2 virus and the widespread nature of infections, have presented multiple pressing questions.Among the unknowns that directly affect newborn and child health are: 1. How does Covid-19 infection duringpregnancy effect the developing fetus or subsequent infant neurodevelopment? And 2. How will theunprecedented scale and scope of concurrent environmental changes impact child health andneurodevelopment? Unfortunately, over the course of the outbreak, the impact on children has been slow to berecognized with studies of Covid-19 infection or effects in infants and young children sparse to nonexistent.Moreover, while the health and economic impacts of the Covid-19 outbreak have been felt by everyone, themost severe effects have be felt by racial and ethnic minorities and lower income families. Thus, the mostsensitive families and children already at risk for worsened neurodevelopmental outcomes aredisproportionately and more intensely affected. Studies of newborns and infants are, therefore, critical todesigning effective guidelines of care for expectant mothers, optimizing early care and support for mothers andtheir newborns, and prioritizing pre- and postnatal interventions. This supplement proposal aims to contributeimportant and timely evidence for these outcomes by characterizing neurodevelopmental profiles in infants bornto mothers with and without antenatal Covid-19 infection, and examining the concurrent impact of social,economic, and substance use factors. Building on two existing and on-going studies of infant neurodevelopment(R34DA050284 and UH3OD023313), with deeply characterised longitudinal neuroimaging, neurocognitive,socioeconomic, demographic, psychosocial and biospecimen data, we will first investigate differences in brainstructure, function, and connectivity development from birth to 1yr of age in infants born to mothers who wereinfected by the SARS-CoV-2 virus during pregnancy and born between May 1, and Sept. 1, 2020, compared toinfants recruited at the same time but to non-infected mothers. We will also examine the impact of infectiontiming during pregnancy and symptom severity on brain measures. Next, we will compare these braindevelopment trends to data from children who turned 1year old prior to Jan. 1, 2020, allowing us to examine theimpact of specific environmental factors, including maternal and infant stress, nutrition, sleep health, and parent-child interaction that have changed due to outbreak-related lock-down and social distancing polices. We willfurther look at these environmental factors through a racial and socioeconomic lens, examining differencesacross race and income dimensions.