Project Summary
The COVID-19 pandemic represents the most significant environmental event in living history and is leading to
unprecedented social, economic and health consequences. There is an urgent need to longitudinally study the
impact of the pandemic on pregnant women and the care they receive, and to understand the consequences for
their children’s birth outcomes and neurobehavioral development. This project adds an eighth site to address
these critical gaps by building upon ongoing harmonized research efforts across seven geographically-
representative sites from the NIH HEALthy Brains and Cognitive Development study (HBCD) initiative, including
New York University, Oregon Health Sciences University, Washington University in St. Louis, University of
Pittsburgh, Cedars Sinai Medical Center, University of Vermont and Northwestern University. We will enroll
pregnant and postpartum women into a multi-wave study in which we assess medical, economic, psychosocial
and substance use risk across pregnancy and the perinatal period, studying associations of these factors to
infant neurobehavioral development during the first year of life. Our central hypotheses include: 1) individual
variation in perinatal COVID-19 related stress leads to differences in birth outcomes, parenting stress and infant
temperament and neurodevelopment and 2) substance use, mental health and economic risk enhance
susceptibility to negative COVID-19 related health and psychosocial outcomes. To pursue these aims,
prospective longitudinal survey, birth and postpartum data will be obtained across a 3-month period in N=50
pregnant and new mothers at our site (providing a total consortium sample of N=750) to generate individual
temporal profiles of COVID-19 related experiences and responses, comparing outcomes with existing data from
maternal-infant cohorts obtained prior to the pandemic. Further, to identify avenues for intervention, we will
evaluate substance use, poor mental health and low social economic status as risk factors and coping, agency
and utilization of resources as resilience factors that influence COVID-19 related maternal stress and child health
and neurobehavioral outcomes. The effects of geographic location will be used to examine the influence of
pandemic severity, variation in local government policies and resource availability on these outcomes. Finally,
we will collect and bank longitudinal perinatal biospecimens in N=20 women at our site that will contribute to a
foundation for future studies to evaluate the biological mechanisms through which the effects on maternal
psychological and physical health influence offspring brain and behavioral development. Through this analysis
of COVID-19 related stress, contextual factors and child outcomes, we will develop comprehensive
understanding of effects and modifiers of this event on health outcomes in individuals that vary in dispositional
risk during perinatal life, one of the most sensitive timepoints in human development.