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Photo: BSIP/UIG via Getty Images

Children of women who had been hospitalized with infections like the flu, pneumonia and sepsis while pregnant may have a much greater risk of having depression or autism spectrum disorder (ASD), according to a study published Wednesday in JAMA Psychiatry.

Why it matters: There's been some debate in the scientific community on whether infections in utero could be a factor in the development of ASD. This large and long-term study — which showed a 79% increased ASD risk and a 24% increased depression risk in those children — offers further evidence there may be a link, plus new information that this could also be a factor in depression, study author Kristina Adams Waldorf tells Axios.

What they did: The researchers used a large dataset of almost 1.8 million Swedish children born between 1973 and 2015, who were observed for up to 41 years using linked population-based registries.

  • "The real power in this study is found in the large numbers of subjects evaluated," Vanderbilt University Medical Center's David Aronoff, who was not part of this study, tells Axios.
  • Data were culled from inpatient hospital records on maternal infections and psychiatric outcomes.
  • The infection types they considered included: maternal infections, urinary tract inflections (UTIs) and severe infections, like sepsis, meningitis or encephalitis, pneumonia, influenza, pyelonephritis or chorioamnionitis.
  • The psychopathologic conditions they were looking for included ASD, bipolar disorder, depression and psychosis, including schizophrenia.
  • The team also wanted to check if the type and severity of the infection affected the magnitude of risk for psychopathologic conditions in the child.

What they found:

  • Fetal exposure to any maternal infection at the hospital — including UTIs — increased the risk of autism and depression, but not bipolar disorder or psychosis.
  • "We analyzed the information in many ways," said Adams Waldorf, a professor at the University of Washington School of Medicine."We found an increased rate of suicide in adults [born from this group] ... which helped corroborate our depression data."

Caveat: Study limitations include the fact that these are only based on women who were hospitalized — "this is not the case for the common cold," Adams Waldorf says — and only on people in Sweden.

  • Another limitation, Aronoff adds, is that these population-level data do not allow close study of patient-level information, such as how individual maternal infections were diagnosed or managed.

Outside comment:

"Studies such as this large Swedish study compel ongoing efforts to develop vaccines to prevent common infections during pregnancy and to more rapidly identify and treat infections that occur despite preventive efforts. [It] suggests that preventing infections during pregnancy might improve neurocognitive and mental health of offspring, which could have far-reaching, beneficial effects on population health and health care expenditures."
— David Aronoff
"Waldorf’s study raises the importance of focusing research on diagnosing the effects of maternal infection on the fetal brain, in utero. In collaboration with MRI experts, our group is investigating whether we can detect the adverse effects of maternal inflammation on the fetal brain, which would allow for the early identification of fetal brain injury and provide a window of opportunity for treating fetuses in utero.”
— Nardhy Gomez-Lopez, professor at Wayne State University, and not part of this study

Meanwhile, Adams Waldorf says pregnant women should talk to their doctors to see if they should get their flu vaccine and have their urine regularly tested for bacteria. Waldorf adds pregnant women should stay away from areas of measles or Zika outbreaks.

Go deeper

State Department to set up new cyber bureau to combat hack attacks

Secretary of State Tony Blinken speaks on the challenges during an October conference in Quito, Ecuador. Photo:y Felipe Stanley/Agencia Press South/Getty Images

Secretary of State Tony Blinken announced Monday plans for the State Department to create a new bureau of cyberspace and digital policy.

Why it matters: The establishment of the bureau and plans for a new envoy to oversee critical and emerging technology come after a series significant hack attacks and other online crimes, notably ransomware assaults on U.S. infrastructure.

Biden rejects Trump's latest executive privilege claims

Photo: Jim Watson and Saul Loeb/AFP via Getty Images

The White House on Monday rejected two more of former President Trump's claims of executive privilege over documents that the House select committee investigating the Jan. 6 Capitol riot requested, CNN first reported.

Why it matters: Trump's legal team is seeking to block some of the panel's requests for records by invoking executive privilege, which can allow presidents and their aides to sidestep congressional scrutiny. The Biden administration has maintained that it will evaluate on a case-by-case basis.

Amazon warehouse workers in New York file petition to hold unionization vote

Amazon workers and their supporters rally outside the National Labor Relations Board's regional office in Brooklyn, New York City, after filing a petition requesting an election to form a union. Photo: Gabby Jones/Bloomberg via Getty Images

Amazon warehouse workers in New York City filed a petition on Monday with the National Labor Relations Board (NLRB) to hold a vote on unionization.

Why it matters: The move comes six months after an organizing effort was defeated at Amazon's distribution center in Alabama.