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Association of Birth During the COVID-19 Pandemic With Neurodevelopmental Status at 6 Months in Infants With and Without In Utero Exposure to Maternal SARS-CoV-2 Infection.

Authors
  • Shuffrey, Lauren C1
  • Firestein, Morgan R1
  • Kyle, Margaret H2
  • Fields, Andrea3
  • Alcántara, Carmela4
  • Amso, Dima3
  • Austin, Judy5
  • Bain, Jennifer M6
  • Barbosa, Jennifer1
  • Bence, Mary2
  • Bianco, Catherine3
  • Fernández, Cristina R2
  • Goldman, Sylvie6
  • Gyamfi-Bannerman, Cynthia7
  • Hott, Violet2
  • Hu, Yunzhe1
  • Hussain, Maha2
  • Factor-Litvak, Pam8
  • Lucchini, Maristella1
  • Mandel, Arthur6
  • And 17 more
  • 1 Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.
  • 2 Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.
  • 3 Department of Psychology, Columbia University, New York, New York.
  • 4 School of Social Work, Columbia University, New York, New York.
  • 5 Heilbrunn Department of Population and Family Health, Columbia University Irving Medical Center, New York, New York.
  • 6 Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, New York.
  • 7 Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla.
  • 8 Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York.
  • 9 Department of Obstetrics and Gynecology, Columbia University Irving Medical Center New York, New York.
  • 10 Department of Neuroscience and Education, Teachers College, Columbia University, New York, New York.
  • 11 New York State Psychiatric Institute, New York.
  • 12 Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York.
Type
Published Article
Journal
JAMA pediatrics
Publication Date
Jun 01, 2022
Volume
176
Issue
6
Identifiers
DOI: 10.1001/jamapediatrics.2021.5563
PMID: 34982107
Source
Medline
Language
English
License
Unknown

Abstract

Associations between in utero exposure to maternal SARS-CoV-2 infection and neurodevelopment are speculated, but currently unknown. To examine 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 age 6 months. A cohort of infants exposed to maternal SARS-CoV-2 infection during pregnancy and unexposed controls was enrolled in the COVID-19 Mother Baby Outcomes Initiative at Columbia University Irving Medical Center in New York City. All women who delivered at Columbia University Irving Medical Center with a SARS-CoV-2 infection during pregnancy were approached. Women with unexposed infants were approached based on similar gestational age at birth, date of birth, sex, and mode of delivery. Neurodevelopment was assessed using the Ages & Stages Questionnaire, 3rd Edition (ASQ-3) at age 6 months. A historical cohort of infants born before the pandemic who had completed the 6-month ASQ-3 were included in secondary analyses. Maternal SARS-CoV-2 infection during pregnancy and birth during the COVID-19 pandemic. Outcomes were scores on the 5 ASQ-3 subdomains, with the hypothesis that maternal SARS-CoV-2 infection during pregnancy would be associated with decrements in social and motor development at age 6 months. Of 1706 women approached, 596 enrolled; 385 women were invited to a 6-month assessment, of whom 272 (70.6%) completed the ASQ-3. Data were available for 255 infants enrolled in the COVID-19 Mother Baby Outcomes Initiative (114 in utero exposed, 141 unexposed to SARS-CoV-2; median maternal age at delivery, 32.0 [IQR, 19.0-45.0] years). Data were also available from a historical cohort of 62 infants born before the pandemic. In utero exposure to maternal SARS-CoV-2 infection was not associated with significant differences on any ASQ-3 subdomain, regardless of infection timing or severity. However, compared with the historical cohort, infants born during the pandemic had significantly lower scores on gross motor (mean difference, -5.63; 95% CI, -8.75 to -2.51; F1,267 = 12.63; P<.005), fine motor (mean difference, -6.61; 95% CI, -10.00 to -3.21; F1,267 = 14.71; P < .005), and personal-social (mean difference, -3.71; 95% CI, -6.61 to -0.82; F1,267 = 6.37; P<.05) subdomains in fully adjusted models. In this study, birth during the pandemic, but not in utero exposure to maternal SARS-CoV-2 infection, was associated with differences in neurodevelopment at age 6 months. These early findings support the need for long-term monitoring of children born during the COVID-19 pandemic.

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