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Association of Maternal Immune Activation during Pregnancy and Neurologic Outcomes in Offspring
Samhita Jain1, Rebecca J Baer2, Charles E McCulloch3
1Division of Neonatology, Department of Pediatrics, University of California, San Francisco, San Francisco, CA.
Insights
Prenatal maternal immune activation (MIA) significantly increases the risk of neurologic morbidity in infants. This includes conditions like seizures and periventricular leukomalacia, highlighting the importance of managing maternal infections during pregnancy.
Area of Science:
- Perinatology
- Neuroscience
- Immunology
Background:
- Maternal immune activation (MIA) is linked to adverse neurodevelopmental outcomes in offspring.
- An inclusive definition of MIA is crucial for comprehensive evaluation.
Purpose of the Study:
- To assess the association between prenatal maternal immune activation (MIA) and neurologic morbidity in infants during their first year of life.
- To explore the impact of MIA on developmental milestones.
Main Methods:
- Retrospective cohort study of singletons born in California (2011-2017).
- MIA defined by ICD diagnoses (infection, autoimmune disorders, allergies, asthma, atherosclerosis, malignancy).
- Neurologic morbidity defined by ICD diagnoses (hemorrhage, leukomalacia, seizures, abnormal exam/imaging).
- Log link binary regression used to approximate risk.
Main Results:
- Infants born to mothers with MIA exhibited higher rates of neurologic morbidities.
- Adjusted relative risks for exposed infants: abnormal neurologic examination (2.0), seizures (1.6), periventricular leukomalacia (1.6).
- Mothers with MIA had a higher rate of preterm delivery (9.4% vs. 5.6%).
Conclusions:
- Maternal immune activation during pregnancy is associated with a substantially increased risk of neurologic morbidity in offspring.
- Findings underscore the potential impact of maternal health on infant neurodevelopment.
Objective:
To evaluate neurologic morbidity among offspring during their first year of life in association with prenatal maternal immune activation (MIA), using an inclusive definition.
Study Design:
This retrospective cohort study included singletons born in California between 2011 and 2017. MIA was defined by International Classification of Diseases diagnosis of infection, autoimmune disorder, allergy, asthma, atherosclerosis, or malignancy during pregnancy. Neurologic morbidity in infants was defined by International Classification of Diseases diagnosis of intraventricular hemorrhage, periventricular leukomalacia, seizures, abnormal neurologic examination, or abnormal neurologic imaging. Outcomes of delayed developmental milestones during the first year of life were also explored. Risk of neurologic morbidity in offspring was approximated for women with and without MIA using log link binary regression.
Results:
Demographic characteristics among 3 004 166 mother-infant dyads with or without MIA were similar in both groups. Rate of preterm delivery in mothers with MIA (9.4%) was significantly higher than those without MIA (5.6%). Infants of mothers with MIA were more likely to experience neurologic morbidities across all gestational ages. Adjusted relative risk (95% CI) in the exposed infants was 2.0 (1.9-2.1) for abnormal neurologic examination; 1.6 (1.5-1.7) for seizures, and 1.6 (1.4-1.8) for periventricular leukomalacia.
Conclusions:
Our results demonstrate that MIA during pregnancy may be associated with considerably higher risk of neurologic morbidity in offspring.
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