Table 2. Risk of Child’s Abnormal Developmental Screen at Ages 12, 18, and 24 Months by In Utero COVID-19 Exposure.
| Covariate | Risk ratio (95% CI) | Adjusted risk ratio (95% CI) | |
|---|---|---|---|
| Model 1a | Model 2b | Model 3c | |
| Time of child developmental delay assessment, mod | |||
| 12 | 1.11 (0.90-1.36) | 1.10 (0.88-1.38) | 1.07 (0.85-1.34) |
| 18 | 1.11 (0.83-1.49) | 1.15 (0.84-1.57) | 1.15 (0.84-1.57) |
| 24 | 1.12 (0.79-1.57) | 0.99 (0.67-1.46) | 1.01 (0.69-1.48) |
| Maternal age | NA | 1.06 (1.03-1.10) | 1.06 (1.02-1.09) |
| Maternal racee | |||
| Asian | NA | 1.29 (0.97-1.73) | 1.36 (1.02-1.80) |
| Black | NA | 1.38 (0.95-2.01) | 1.30 (0.88-1.91) |
| Multiracial or otherf | NA | 0.97 (0.68-1.38) | 1.05 (0.74-1.48) |
| Maternal Hispanic ethnicityg | NA | 1.01 (0.79-1.30) | 1.00 (0.78-1.28) |
| Educational levelh | |||
| College degree | NA | 1.07 (0.85-1.34) | 1.09 (0.88-1.37) |
| Graduate degree | NA | 1.06 (0.84-1.33) | 1.04 (0.83-1.31) |
| Yearly household income, $i | |||
| 50 000-99 999 | NA | 0.81 (0.64-1.04) | 0.79 (0.62-1.00) |
| 100 000-250 000 | NA | 0.69 (0.54-0.88) | 0.70 (0.55-0.89) |
| >250 000 | NA | 0.62 (0.46-0.84) | 0.64 (0.47-0.86) |
| Mild to severe GAD-7 scorej | NA | 1.23 (1.07-1.42) | 1.25 (1.09-1.44) |
| Mild to severe PHQ-9 scorej | NA | 0.92 (0.80-1.05) | 0.92 (0.79-1.05) |
| Enrollment to vaccine availability, wkk | NA | 0.99 (0.98-1.00) | 0.99 (0.98-1.00) |
| Preterm birth (<37 wk’ gestation)l | NA | NA | 1.54 (1.19-1.99) |
| Female infant sexm | NA | NA | 0.74 (0.65-0.85) |
Abbreviations: GAD-7, Generalized Anxiety Disorder 733 (scores range from 0 to 21 points, with higher scores indicating a severe level of anxiety); NA, not applicable; PHQ-9, Patient Health Questionnaire34 (scores range from 0 to 27, with higher scores indicating the presence of severe depressive symptoms).
Unadjusted mixed-effects model including only the month of the Ages & Stages Questionnaire, Third Edition measurement; infection status; a month-by-infection interaction term; and random intercepts for participants.
Adjusted for covariates measured at baseline (chosen a priori, as shown in Table 1) including maternal age, race, ethnicity, educational level, household income, mild to severe general anxiety (based on the GAD-7), mild to severe depression (based on the PHQ-9), and the duration of time between enrollment and the time at which COVID-19 vaccines became available to all adults (April 19, 2021).
Adjusted for covariates measured at baseline and infant sex and preterm birth (delivered <37 weeks’ gestation).
Data are for prenatal infection (no prenatal infection is the reference). Estimates are generated using marginal probabilities from models containing an interaction between month and infection status. Mean imputation was used for maternal age in models 2 and 3 for those missing age (238 [12%]). A missing infant sex category was included in model 3 for those missing sex (260 [13%]).
White is the reference.
Multiracial includes participants who identified as any combination of Asian, Black, Native American, Pacific Islander, or White; other includes those who identified with groups not explicitly listed.
Non-Hispanic is the reference.
No college degree is the reference.
Less than $50 000 is the reference.
None to minimal is the reference.
COVID-19 vaccine availability began on April 19, 2021, for all adults in the US, including Puerto Rico and other territories.
Not premature is the reference.
Male is the reference.