Pandemic poses short- and long-term risks to babies, especially boys

Pandemic poses short- and long-term risks to babies, especially boys

The pandemic has created a hostile environment for pregnant people and their babies.

Stress levels among expectant mothers have soared. Pregnant women with Covid are five times as likely as uninfected pregnant people to require intensive care and 22 times as likely to die. Infected moms are four times as likely to have a stillborn child.

Yet some of the pandemic’s greatest threats to infants’ health may not be apparent for years or even decades.

Full coverage of the Covid-19 pandemic

That’s because babies of Covid-infected moms are 60 percent more likely to be born very prematurely, which increases the danger of infant mortality and long-term disabilities such as cerebral palsy, asthma and hearing loss, as well as a child’s risk of adult disease, including depression, anxiety, heart disease and kidney disease.

Studies have linked fever and infection during pregnancy to developmental and psychiatric conditions such as autism, depression and schizophrenia.

“Some of these conditions do not show up until middle childhood or early adult life, but they have their origins in fetal life,” said Dr. Evdokia Anagnostou, a neurologist and pediatrics professor at the University of Toronto.

For fetuses exposed to Covid, the greatest danger is usually not the coronavirus itself, but the mother’s immune system.

Both severe Covid infections and the strain of the pandemic can expose fetuses to harmful inflammation, which can occur when a mother’s immune system is fighting a virus or when stress hormones send nonstop alarm signals.

Prenatal inflammation “changes the way the brain develops and, depending on the timing of the infection, it can change the way the heart or kidneys develop,” Anagnostou said.

Although health officials have strongly recommended Covid vaccines for pregnant people, only 35 percent are fully vaccinated.

At least 150,000 pregnant people have been diagnosed with Covid; more than 25,000 of them have been hospitalized, and 249 have died, according to the Centers for Disease Control and Prevention.

Although most babies will be fine, even a small increase in the percentage of children with special medical or educational needs could have a large effect on the population, given the huge number of Covid infections, Anagnostou said.

“If someone has a baby who is doing well, that is what they should focus on,” Anagnostou said. “But from a public health point of view, we need to follow women who experienced severe Covid and their babies to understand the impact.”

Learning from history

Researchers in the United States and other countries are already studying “the Covid generation” to see whether these children have more health issues than those conceived or born before 2020.

Previous crises have shown that the challenges fetuses face in the womb — such as maternal infections, hunger, stress and hormone-disrupting chemicals — can leave a lasting imprint on their health, as well as that of their children and grandchildren, said Dr. Frederick Kaskel, director of pediatric nephrology at the Children’s Hospital at Montefiore.

People whose

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Rise of syphilis in the U.S reflects neglect of long-term public health funding : Shots

Rise of syphilis in the U.S reflects neglect of long-term public health funding : Shots

Mai Yang, a communicable disease specialist, searches for Angelica, a 27 year-old pregnant woman who tested positive for syphilis, in order to get her treated before she delivers her baby.

Talia Herman for ProPublica


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Talia Herman for ProPublica


Mai Yang, a communicable disease specialist, searches for Angelica, a 27 year-old pregnant woman who tested positive for syphilis, in order to get her treated before she delivers her baby.

Talia Herman for ProPublica

When Mai Yang is looking for a patient, she travels light. She dresses deliberately — not too formal, so she won’t be mistaken for a police officer; not too casual, so people will look past her tiny 4-foot-10 stature and youthful face and trust her with sensitive health information. Always, she wears closed-toed shoes, “just in case I need to run.”

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Yang carries a stack of cards issued by the Centers for Disease Control and Prevention that show what happens when the Treponema pallidum bacteria invades a patient’s body. There’s a photo of an angry red sore on a penis. There’s one of a tongue, marred by mucus-lined lesions. And there’s one of a newborn baby, its belly, torso and thighs dotted in a rash, its mouth open, as if caught midcry.

It was because of the prospect of one such baby that Yang found herself walking through a homeless encampment on a blazing July day in Huron, Calif., an hour’s drive southwest of her office at the Fresno County Department of Public Health.

She was looking for a pregnant woman named Angelica, whose visit to a community clinic had triggered a report to the health department’s sexually transmitted disease program. Angelica had tested positive for syphilis. If she was not treated, her baby could end up like the one in the picture or worse — there was a 40% chance the baby would die.

Yang knew, though, that if she helped Angelica get treated with three weekly shots of penicillin at least 30 days before she gave birth, it was likely that the infection would be wiped out and her baby would be born without any symptoms at all. Every case of congenital syphilis, when a baby is born with the disease, is avoidable. Each is considered a “sentinel event,” a warning that the public health system is failing.

The alarms are now clamoring. In the United States, more than 129,800 syphilis cases were recorded in 2019, double the case count of five years prior. In the same time period, cases of congenital syphilis quadrupled: 1,870 babies were born with the disease; 128 died. Case counts from 2020 are still being finalized, but the CDC has said that reported cases of congenital syphilis have already exceeded the prior year. Black, Hispanic and Native American babies are disproportionately at risk.

Yang drives to Huron, a rural town an hour

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