Background
Associations between in utero exposure to maternal SARS-CoV-2 infection and neurodevelopment are widely speculated, but currently unknown. Here, we sought to determine the associations between maternal SARS-CoV-2 infection during pregnancy, being born during the COVID-19 pandemic regardless of maternal SARS-CoV-2 status, and neurodevelopment at 6-months.
Methods
Infants exposed to maternal SARS-CoV-2 infection during pregnancy and unexposed controls were enrolled into the COVID-19 Mother Baby Outcomes (COMBO) initiative at Columbia University Irving Medical Center (CUIMC) in New York City. Of 1706 women approached, 596 enrolled and 70.6% of 385 women invited to a 6-month assessment completed the Ages and Stages Questionnaire, 3rd Edition (ASQ-3) at 6-months of age. Data were available for 255 COMBO infants (114 in utero exposed, 141 unexposed). Data on the ASQ-3 was also available from a historical cohort of 62 infants born at CUIMC prior to the pandemic.
Results
In utero exposure to maternal SARS-CoV-2 infection was not associated with differences on any ASQ-3 subdomain regardless of infection timing or severity. However, infants born during the pandemic had significantly lower scores on gross motor (mean difference -5.63, 95%CI[-8.75;-2.51], F1, 267=12.63, p<0.005), fine motor (mean difference -6.61, 95%CI[-10.00;-3.21], F1, 267=14.71, p<0.005), and personal-social (mean difference -3.71, 95%CI[-6.61;-0.82], F1, 267=6.37, p<0.05) subdomains when compared to the historical cohort.
Conclusions
Birth during the pandemic, but not maternal SARS-CoV-2 infection, was associated with differences in neurodevelopment at 6-months. These early findings suggest significantly higher public health impact for the generation born during the COVID-19 pandemic than previously anticipated.
Funding Source
R01MH126531
Keywords
COVID-19 Pandemic, Neurodevelopment, ASQ-3