The rubella pandemic of 1964 was associated with a 10–15-fold increase in ASD and schizophrenia in offspring. For example, individuals who were fetuses during the 1957 influenza pandemic had an increased risk for being hospitalized for schizophrenia as adults. Past pandemics have provided a window into potential neurodevelopmental consequences in subsequent generations. Adverse neurodevelopmental outcomes observed following prenatal infection range from autism spectrum disorder (ASD), attention deficit hyperactivity disorder, and cognitive dysfunction, to anxiety, depression, and schizophrenia. Other infections that do not cross the placental barrier, including viral infections such as influenza, have also been consistently associated with adverse neurodevelopmental outcomes in offspring, primarily via mechanisms related to maternal, placental, and subsequent fetal brain immune activation. Those viruses that demonstrate neuroinvasion and neurotropism – that is, the ability to invade the blood–brain barrier and infect neurologic tissues, such as Zika virus or cytomegalovirus – can directly damage the developing fetal brain if transplacental transmission occurs.
Some viral infections acquired antenatally can have lasting, potentially devastating, impacts on the developing fetal brain.
Potential transgenerational impact of viral infections in pregnancy
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