PROJECT SUMMARY Societal consequences of the COVID-19 pandemic are unprecedented. The global community has been crippled by a public health emergency that has had deleterious health and economic impacts, the scope of which has yet to be determined. As a result of the current crisis, pregnant women and new mothers are currently experiencing dramatic loss of medical, financial, and social support, resulting in higher rates of emotional distress. It is well established that chronic stress can be embedded in the developing neurobiological system, particularly during sensitive periods of life, but how the timing of maternal stressors and pathways through which these experiences impact child neurobehavioral development are unclear. The central objective of this proposal is to examine the association between perinatal COVID-19 stress and longitudinal postnatal brain development, and to rigorously evaluate timing of exposure, underlying biological mechanisms and postnatal protective factors. We will enroll 300 women and children from the New York City (NYC) COVID-19 Perinatal Experiences (COPE) cohort into a longitudinal protocol that will measure child biobehavioral outcomes at 12-, 24-, and 36-months. The COPE cohort is comprised of more than 900 women that were enrolled into a longitudinal assessment protocol at the height of the pandemic, approximately half of which were pregnant (54%) and half of which were new mothers (46%). The primary aims of this project are to (i) identify key windows of perinatal stress vulnerability; (ii) evaluate biological pathways that underlie associations between maternal COVID-19 stressors and infant neurocognition; and (iii) isolate protective factors in the postnatal environment that promote resilient outcomes in children exposed to extreme perinatal stress. We will selectively recruit the proposed subsample for this study based on balance of timing of exposure, severity of stressors, and sociodemographic factors. We will thus be able to meaningfully evaluate biological consequences of perinatal stress with control over both timing and aggregate risk. Such work would constitute a substantial advance in our understanding of the longitudinal effects of maternal perinatal stress on early human brain development and would also offer potential avenues for promoting healthy outcomes in children born at the height of history’s most significant perinatal stressor.

PROJECT NARRATIVE There is an urgent need to identify the psychosocial impacts of the COVID-19 pandemic on pregnant women and their infants. The goal of this project is to examine consequences and mechanisms of COVID-related maternal stress, and to isolate protective postnatal factors that can inform future interventions relevant to children born around the world at this utterly challenging time.