Neurodevelopmental delay in children exposed to maternal SARS-CoV-2 in-utero

• Published in: Scientific reports Vol. 14; no. 1; p. 11851
• Main Authors: Fajardo-Martinez, Viviana, Ferreira, Fatima, Fuller, Trevon, Cambou, Mary Catherine, Kerin, Tara, Paiola, Sophia, Mok, Thalia, Rao, Rashmi, Mohole, Jyodi, Paravastu, Ramya, Zhang, Dajie, Marschik, Peter, Iyer, Sai, Kesavan, Kalpashri, Borges Lopes, Maria da Conceição, Britto, José Augusto A., Moreira, Maria Elisabeth, Brasil, Patricia, Nielsen-Saines, Karin
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 24.05.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308/3187; 692/699/255/2514; Adult; Age; Brazil - epidemiology; Child Development; Child, Preschool; Children; COVID-19; COVID-19 - epidemiology; Developmental Disabilities - epidemiology; Developmental Disabilities - etiology; Developmental Disabilities - virology; Female; Humanities and Social Sciences; Humans; Infant; Infants; Los Angeles - epidemiology; Male; multidisciplinary; Neurodevelopment; Neurodevelopmental Disorders - etiology; Neurodevelopmental Disorders - virology; Pandemics; Pediatrics; Pregnancy; Pregnancy Complications, Infectious - virology; Prenatal Exposure Delayed Effects - virology; Problem solving; SARS-CoV-2 - isolation & purification; Science; Science (multidisciplinary); Severe acute respiratory syndrome coronavirus 2; Brazil; Los Angeles
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-61918-2

It is unclear if SARS CoV-2 infection during pregnancy is associated with adverse neurodevelopmental repercussions to infants. We assessed pediatric neurodevelopmental outcomes in children born to mothers with laboratory-confirmed SARS CoV-2 infection during pregnancy. Neurodevelopmental outcomes of in-utero exposed children were compared to that of pre-pandemic control children in Los Angeles (LA), CA, USA and Rio de Janeiro, Brazil. Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III), the gold standard tool for evaluating neurodevelopment until 36 months of age and Ages and Stages Questionnaires (ASQ-3), a frequently used screening instrument for evaluating neurodevelopment in this same age group were the assessment tools used. Developmental delay (DD) was defined as having a score < − 2 SD below the norm (< 70) in at least one of three Bayley-III domains, (cognitive, motor or language) or a score below the cut-off (dark zone) in at least one of five ASQ-3 domains (communication, gross motor, fine motor, problem solving, personal-social). Exposed children were born between April 2020 and December 2022 while control children were born between January 2016 to December 2019. Neurodevelopmental testing was performed in 300 children total: 172 COVID-19 exposed children between 5–30 months of age and 128 control children between 6–38 months of age. Bayley-III results demonstrated that 12 of 128 exposed children (9.4%) had DD versus 2 of 128 controls (1.6%), p  = 0.0007. Eight of 44 additional exposed children had DD on ASQ-3 testing. Fully, 20 of 172 exposed children (11.6%) and 2 of 128 control children (1.6%), p  = 0.0006 had DD. In Rio, 12% of exposed children versus 2.6% of controls, p  = 0.02 had DD. In LA, 5.7% of exposed children versus 0 controls, p  = 0.12 had DD. Severe/critical maternal COVID-19 predicted below average neurodevelopment in the exposed cohort (OR 2.6, 95% CI 1.1–6.4). Children exposed to antenatal COVID-19 have a tenfold higher frequency of DD as compared to controls and should be offered neurodevelopmental follow-up.