Investigating the impact of distinct pandemic prenatal stressors on early immune disruptions in children via alterations to prenatal inflammatory pathways

During the COVID-19 pandemic, there was an increase in psychological (e.g., anxiety), environmental (e.g., financial hardship), and viral stress (e.g., SARS-CoV-2 infection). Pregnant individuals were very vulnerable as sustained stress and exposure to infection magnifies the risk of health consequences for the fetus. Our research program examines the impact of viral, psychological, and environmental pandemic-related prenatal stress on indicators of immune disruption in children via alterations to prenatal inflammation. This research leverages the Pregnancy during the Pandemic cohort (a pan-Canadian sample of n>11,000 recruited prior to widely available vaccines [April 2020 -2021]) to investigate the impact of prenatal stress on the following immune-mediated child conditions: asthma, allergic diseases, and inflammatory skin conditions. In the proposed study, we compare the strength of associations between cumulative prenatal stress on child health conditions and the unique relationship of each type of prenatal stress on child health. We hypothesize that viral stress (confirmed via antibody COVID-19 testing) will have the most robust association with medical diagnosis of child health conditions. The second aim will test the degree to which prenatal parent inflammation mediates the association between prenatal stressors and child health conditions; specifically investigating C-reactive protein brain-derived neurotrophic factor levels. Lastly, we will investigate gestational age and fetal sex potential moderators. Prenatal stress has been linked to later-onset health problems. This study will help to disambiguate unique contributions of types of prenatal stress and connect this to early signs of health degradation. The study also considers the mechanistic contributions of parental inflammation on these complex relationships. Ultimately, these results can help inform developing interventions aimed at supporting vulnerable populations during the COVID-19 pandemic.