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The Impact of the COVID-19 Lock-down on the Levels of Anxiety and Depression of Pregnant Women Leading to Cognitive Disorders in the Fetus

By Hareem Bilal and Dr. Austin Mardon

The COVID-19 pandemic has led to social isolation and quarantine precautions
in response to the virus, and have negatively impacted the lives of many worldwide. Changes In physical activity, sedentary lifestyle, food consumption, and psychological levels have also been reported.1 The affected population includes pregnant women who are particularly more vulnerable considering that 10% to 25% percent of pregnant women are generally affected by anxiety and depression.2 Increased psychological distress during the lockdown can lead to increased obstetric complications, which could negatively affect child development. 3 A rise in prenatal stress (PNS) can negatively affect the cognitive development of the fetus, resulting in cognitive disorders.4
Critical brain development occurs from 3 -16 weeks gestational age in the fetus.
Closure of the neural tube occurs at around 3 weeks gestational age, while
neurogenesis is completed by 16 weeks of embryonic life.5 Prenatal stress during this critical period has detrimental effects on the neurodevelopment of the fetus, which could lead to neurodevelopmental defects in the neonate.6 PNS can cause impairment in the cognitive performance of infants and a decrease in brain volume in the areas for learning and memory of 6-8-year-olds.7 PNS can lead to developmental disorders such as Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). ASD and ADHD are life-long cognitive disorders, which begin in early childhood development, where males are more likely to develop ADHD and ASD than their female counterparts.8 In a study, 2900 pregnant women were recruited before the 18th week of their pregnancy. When their children were born and reached the age of two, they were asked to fill out a questionnaire. Mothers under maternal stress checked off signs that showed ADHD in their children.9
Individuals with ADHD have a great chance of suffering from childhood through adulthood, as they usually show signs of poor attention, distractibility, impulsiveness, and hyperactivity. These individuals usually have poor academic standing in school, have behavioral problems at home, and have a higher rate of school dropout. ADHD can even physically harm the individual suffering from the disorder, as these individuals are noted to have a higher rate of motor vehicle crashes and substance use.10 There are several other cognitive deficits caused by prenatal stress that can negatively impact the lives of children during their lifetime.
Another cognitive disorder caused by prenatal maternal stress is Autism (ASD); a
cognitive and developmental disorder. ASD surfaces in early childhood, where
individuals suffering from ASD are prone to problematic behaviors and suffer from
lower life satisfaction. Autistic children show signs of impairment in social and
communication skills, displaying repetitive behaviors and peculiar interests. They are less likely to participate in any physical, club, or team building activities. Thus, lower life satisfaction is reported in children suffering from Autism.11
Maternal stress has detrimental consequences on the development of embryonic
life. PNS during the sensitive period of 3-16 weeks gestational age can increase
postnatal neurodevelopmental deficits such as ADHD and ASD. Cognitive disorders
such as Autism and ADHD can have a negative long-term effect on the neonate. These neurodevelopmental disorders can decrease overall life satisfaction in affected individuals. PNS caused by social isolation due to the COVID-19 pandemic can increase psycho-emotional distress in women, which in turn could have unfortunate consequences for the unborn children. Policies regarding childcare during the pandemic are essential, as women carrying children in their womb might not be aware of the significance of PNS on the fetus. Awareness of prenatal stress and its consequences should be promoted during the COVID-19 pandemic. It is important for any society to take precautions and equip themselves with knowledge of the significance of PNS, especially during a global crisis.

1 Stanton et al., 2020
2 Lebel et al., 2020
3 Takeda et al., 2021
4 Kinsella & Monk, 2009
5 Gale et al., 2004
6 Fatima et al., 2019
7 Sandman et al., 2012
8 Ronald et al., 2011
9 Ronald et al., 2011
10 Felt et al., 2014
11 Xu et al., 2019

1) Fatima, M., Srivastav, S., Ahmad, M. H., & Mondal, A. C. (2019). Effects of
chronic unpredictable mild stress induced prenatal stress on neurodevelopment
of neonates: Role of GSK-3β. Scientific Reports, 9(1), 1.
2) Felt, B. T., Biermann, B., Christner, J. G., Kochhar, P., & Harrison, R. V. (2014).
Diagnosis and management of ADHD in children. American family physician,
90(7), 456–464.
3) Gale, C. R. (2004). Critical periods of brain growth and cognitive function in
children. Brain, 127(2), 321–329.
4) KINSELLA, M. I. C. H. A. E. L. T., & MONK, C. A. T. H. E. R. I. N. E. (2009).
Impact of Maternal Stress, Depression and Anxiety on Fetal Neurobehavioral
Development. Clinical Obstetrics & Gynecology, 52(3), 425–440.
5) Lebel, C., MacKinnon, A., Bagshawe, M., Tomfohr-Madsen, L., & Giesbrecht, G.
(2020). Elevated depression and anxiety symptoms among pregnant individuals
during the COVID-19 pandemic. Journal of Affective Disorders, 277, 5–13.
6) Stanton, R., To, Q. G., Khalesi, S., Williams, S. L., Alley, S. J., Thwaite, T. L.,
Fenning, A. S., & Vandelanotte, C. (2020). Depression, Anxiety and Stress during

About Writers:

Hareem Bilal is a student in the Faculty of Science at Alberta University Canada. Austin Mardon, PhD, CM, FRSC, is an Adjunct Professor in the Faculty of Medicine and Dentistry at the University of Alberta.