Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Aug 12;14(16):3303.
doi: 10.3390/nu14163303.

Fetal Brain Damage during Maternal COVID-19: Emerging Hypothesis, Mechanism, and Possible Mitigation through Maternal-Targeted Nutritional Supplementation

Chiara Germano  1   2 , Alessandro Messina  2 , Elena Tavella  3 , Raffaele Vitale  3 , Vincenzo Avellis  3 , Martina Barboni  2 , Rossella Attini  2 , Alberto Revelli  2 , Paolo Zola  2 , Paolo Manzoni  1 , Bianca Masturzo  1
Affiliations
Review

Fetal Brain Damage during Maternal COVID-19: Emerging Hypothesis, Mechanism, and Possible Mitigation through Maternal-Targeted Nutritional Supplementation

Chiara Germano et al. Nutrients. .

Abstract

The recent outbreak of the novel Coronavirus (SARS-CoV-2 or CoV-2) pandemic in 2019 and the risk of CoV-2 infection during pregnancy led the scientific community to investigate the potential negative effects of Coronavirus infection on pregnancy outcomes and fetal development. In particular, as CoV-2 neurotropism has been demonstrated in adults, recent studies suggested a possible risk of fetal brain damage and fetal brain development impairment, with consequent psychiatric manifestations in offspring of mothers affected by COronaVIrus Disease (COVID) during pregnancy. Through the understanding of CoV-2's pathogenesis and the pathways responsible for cell damage, along with the available data about neurotropic virus attitudes, different strategies have been suggested to lower the risk of neurologic disease in newborns. In this regard, the role of nutrition in mitigating fetal damages related to oxidative stress and the inflammatory environment during viral infection has been investigated, and arginine, n3PUFA, vitamins B1 and B9, choline, and flavonoids were found to be promising in and out of pregnancy. The aim of this review is to provide an overview of the current knowledge on the mechanism of fetal brain damage and the impact of nutrition in reducing inflammation related to worse neurological outcomes in the context of CoV-2 infections during pregnancy.

Keywords: COVID-19; fetal brain damage; nutrition; pregnancy; prevention; supplementation in pregnancy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
SARS-CoV-2 entry pathways. The cell surface entry pathway requires Spike viral protein to bind ACE2 bolstered by TMPRSS2, which promotes the fusion of the viral capsid with the host cell. If the cell expresses insufficient TMPRSS2 or if the virus–ACE2 complex does not face TMPRSS2, the virus–ACE2 complex is internalized via clathrin-mediated endocytosis. ACE2, angiotensin-2 converting enzyme; TMPRSS2, transmembrane protease serine 2.
Figure 2
Figure 2
SARS-CoV-2 direct CNS damage mechanism. CNS, central nervous system; ACE2, angiotensin-2 converting enzyme; TMPRSS2, transmembrane protease serine 2.
Figure 3
Figure 3
SARS-CoV-2 indirect CNS damage mechanism. CNS, central nervous system. ↓: increase ↑: decrease.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. de Vries L.S. Viral Infections and the Neonatal Brain. Semin. Pediatr. Neurol. 2019;32:100769. doi: 10.1016/j.spen.2019.08.005. - DOI - PubMed
    1. Kraus T.A., Engel S.M., Sperling R.S., Kellerman L., Lo Y., Wallenstein S., Escribese M.M., Garrido J.L., Singh T., Loubeau M., et al. Characterizing the pregnancy immune phenotype: Results of the viral immunity and pregnancy (VIP) study. J. Clin. Immunol. 2012;32:300–311. doi: 10.1007/s10875-011-9627-2. - DOI - PMC - PubMed
    1. Pazos M., Sperling R.S., Moran T.M., Kraus T.A. The influence of pregnancy on systemic immunity. Immunol. Res. 2012;54:254–261. doi: 10.1007/s12026-012-8303-9. - DOI - PMC - PubMed
    1. Priddy K.D. Immunologic adaptations during pregnancy. J. Obstet. Gynecol. Neonatal. Nurs. 1997;26:388–394. doi: 10.1111/j.1552-6909.1997.tb02720.x. - DOI - PubMed
    1. Sappenfield E., Jamieson D.J., Kourtis A.P. Pregnancy and susceptibility to infectious diseases. Infect. Dis. Obstet. Gynecol. 2013;2013:752852. doi: 10.1155/2013/752852. - DOI - PMC - PubMed