TY - JOUR T1 - Can SARS-CoV-2 Be a Potential Cause of Microcephaly? AU - Özbörü Aşkan, Öykü AU - Keskindemirci, Gonca AU - Bakır, Alev AU - Gökçay, Gülbin PY - 2025 DA - February Y2 - 2024 DO - 10.26650/jchild.2024.1557648 JF - Çocuk Dergisi PB - Istanbul University WT - DergiPark SN - 1308-8491 SP - 255 EP - 256 VL - 24 IS - 4 LA - en AB - Dear Editor,Microcephaly (MC) is defined as a head circumference with a standard deviation score (SDS) below -2 according to some experts and below -3 according to others (1-3). In our clinic, we use the criterion of head circumference below -2 SDS to define MC. MC can be classified as primary if present at birth, or as secondary if it develops postnatally (2, 4, 5). Several risk factors have been associated with MC, including genetic disorders, teratogenic exposure, maternal age, maternal phenylketonuria, and hypoxic-ischemic encephalopathy. Keskindemirci et al. also highlighted that socioeconomic factors may play a role in the risk of MC (6). Among these, maternal infections during pregnancy are the leading causes of microcephaly, with Rubella, Zika virus, and cytomegalovirus (CMV) being the most recognized infectious etiologies (2, 4). The impact of COVID-19 on fetal development during pregnancy has not been fully elucidated. There are reports in the literature suggesting that SARS-CoV-2 infection during pregnancy may lead to complications (7). We read with interest the recent article by Edlow et al., which concluded that “COVID-19 exposure may be associated with neurodevelopmental changes and highlights the need for prospective investigation of outcomes in children exposed to COVID-19 in utero” (8). Moreover, Auger et al., in their time series analysis, observed an increased frequency of microcephaly during the COVID-19 pandemic period (9). CR - Woods, C.G. CG, Parker A. Investigating microcephaly. Arch Dis Child 2013; 98: 707-713. google scholar CR - Von der Hagen M, Pivarcsi M, Liebe J, Von Bernuth H, Didonato N, Hennermann JB, et al. Diagnostic approach to microcephaly in childhood: a two-center study and review of the literature. Dev Med Child Neurol 2014; 56: 732-741. google scholar CR - Hanzlik E, Gigante J. Microcephaly. Children (Basel). 2017; 4: 47. google scholar CR - DeSilva M, Munoz FM, Sell E, Marshall H, Tse Kawai A, Kachikis A et al. Brighton Collaboration Congenital Microcephaly Working Group Congenital microcephaly: Case definition & guidelines for data collection, analysis, and presentation of safety data after maternal immunization, 2017; 35: 6472-6482. google scholar CR - Ashwal S, Michelson D, Plawner L, Dobyns WB. Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Practice parameter: Evaluation of the child with microcephaly (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2009; 15: 887-97. google scholar CR - Keskindemirci G, Özbörü Aşkan Ö, Selver B, Bakır Kayı A, Gökçay G. Microcephaly in Infants: A Retrospective Cohort Study from Turkey. J Clin Res Pediatr Endocrinol. 2024;16:168-176. google scholar CR - Rad HS, Röhl J, Stylianou N, Allenby MC, Bazaz SR, Warkiani ME, et al. The Effects of COVID-19 on the Placenta During Pregnancy. Front Immunol. 2021 Sep 15;12:743022 google scholar CR - Edlow AG, Castro VM, Shook LL, Kaimal AJ, Perlis RH. Neurodevelopmental Outcomes at 1 Year in Infants of Mothers Who Tested Positive for SARS-CoV-2 During Pregnancy. JAMA Netw Open. 2022;5(6):e2215787 google scholar CR - Auger N, Arbour L, Lewin A, Brousseau E, Healy-Profitos J, Luu TM. Congenital anomalies during Covid-19: artifact of surveillance or a real TORCH? Eur J Epidemiol. 2024; 39(6):613-621 google scholar UR - https://doi.org/10.26650/jchild.2024.1557648 L1 - https://dergipark.org.tr/en/download/article-file/4247915 ER -