Will babies born during the pandemic live with long-term trauma?

The collective stress caused by the ongoing pandemic has become so all-encompassing, it has opened up a scientific debate over whether babies born during lockdowns will suffer from poorer health for the rest of their lives. If you’re wondering why that might happen, scientists say you can look no further than the North American Ice Storm of 1998.

For up to six weeks after the storm knocked out power across eastern Ontario and southern Quebec, pregnant women had to grapple with ice-cold temperatures at home—and that left a biological mark on their babies, says University of Calgary radiologist Catherine Lebel. The Project Ice Storm study scanned the brains of 35 boys and 33 girls whose mothers were pregnant during the event to see if the storm had any influence on the amygdala, a part of the brain involved with regulating emotions.

The research found that babies born during the disaster had larger amygdalas a decade later. These enlargements paralleled a greater frequency in aggressive behaviors, particularly in girls. Prenatal stress is thought to influence the early growth of the amygdala, both in humans and rodents, and its size may influence whether someone develops depression, anxiety, or aggression.

Lebel is now leading a long-term study that will monitor pregnant women across Canada on a monthly basis and will follow their infants’ outcomes after birth to see whether isolation due to stay-at-home orders will have a similar impact on babies born during the coronavirus era. “It is foolish to dismiss the prenatal period,” Lebel says.

Lebel and other researchers say the inordinate strain and isolation these women are experiencing may be affecting their fetuses, which, by their reckoning, could lay the foundations for “Generation C” to display a slew of cognitive, mental, emotional, and physical conditions.

In May, Sam Schoenmakers at the Erasmus University Medical Center in Rotterdam, the Netherlands, and four other obstetricians, neonatologists, and medical ethicists published an opinion piece in the British Medical Journal that described the “collateral damage” pandemic-born babies might confront. They note that some reports cite higher rates of antisocial personality disorder and shorter lifespans for children born during famines caused by Nazi occupations in the western part of the Netherlands in the 1940s. Likewise, studies on the aftermath of 2012’s Superstorm Sandy outline changes in temperament in children born to women who were pregnant when the disaster struck; these children were more fearful and sad, as well as less cuddly and pleasure-seeking.

Lebel’s COVID-19 project has already yielded some worrying results. In April, the team recruited nearly 2,000 pregnant participants to fill out psychological questionnaires. Among those surveyed, 37 percent reported clinically relevant symptoms of depression, and 57 percent expressed signs of anxiety. Based on the evidence from the past, this strain on pregnant women may be causing physiological changes in their developing babies.

But not everyone thinks “coronababies” are necessarily destined for difficulty. Noel Hunter, a clinical psychologist and author of Trauma and Madness in Mental Health Services, says that the concept of collateral damage is overgeneralized and based on scant statistics.

“Previous research showed only correlation between later problems in the physical and mental health of babies, and not causation,” Hunter says. For her, these correlations neglect the ways stressful situations (like an ongoing pandemic) can influence adult behaviors toward children. Rather than blame parents’ bodies and the prenatal period, Hunter says, the focus should be expanded to study persistent traumas that can influence kids long after birth, such as abusive parenting and childhood stress, which have also been linked to long-term health consequences.

Other experts argue that any research must factor in how COVID-19 intersects with vulnerabilities that already exist due to systemic racism or income inequality. Alisha Ali, an applied psychologist at New York University, points to large institutional problems that have now been thrown into stark relief, from poor healthcare for people of color, to urban food deserts and heat islands created in large part by racist policies. (Here’s how decades of redlining reshaped urban landscapes, creating oppressively hot neighborhoods.)

“People who were already more likely to have babies who are at risk of not being able to reap the benefits of proper nutrition, medical care, and related resources are now at even greater risk,” Ali says.

Lebel herself takes a moderate stance when it comes to using heated terms like “collateral damage,” even though she does expect some lingering consequences in pandemic babies.

“I wouldn’t talk about a damaged generation,” Lebel says. “But 20 years from now, we’re going to see higher rates of depression and anxiety than what we did in previous generations.”

Understanding whether the pandemic will influence coronababies will take time, but for now, parents can do things to minimize the effects. For example, early results from Lebel’s study on COVID-19 showed that social support and increased physical activity were associated with fewer symptoms of anxiety and depression among the pregnant women they surveyed.

Fostering relationships—even virtual or socially distant ones—can help with the dual experiences of stay-at-home isolation and being overwhelmed by the new responsibilities of parenthood. For parents of all backgrounds, the importance of a robust social support system cannot be overstated, Ali says.

“It should be part of an expectant parent’s plan from the very beginning,” she says. “Having just one supportive person you trust—whether these be a spouse, a parent, or a close friend—can serve a preventive role when it comes to physical and mental health problems, and this support can be virtual.”

That said, parents facing social vulnerabilities may require extra assistance. Apart from making sure these parents have better nutrition for themselves and their newborns, health-care workers must also guarantee they have ongoing social support, Ali says. Having a nurse or a social worker call to check in regularly after the baby is born, and not just over the first postpartum days, could potentially head off any mental and physical health problems.

Hunter recommends finding amusing activities such as playing a board game, singing karaoke, making a TikTok video, or going on a scavenger hunt. Similarly, parents can benefit from learning a new skill, and making time to laugh or to grieve if they’ve lost a loved one. Sleep and nutrition also remain as important as ever for a healthy pregnancy and postpartum period.

“Kids will mostly be fine if their parents take care of themselves and focus on what is most meaningful in life,” Hunter says. “When we work together and support one another, we can overcome almost anything.”