TY - JOUR
T1 - 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
AU - Shuffrey, Lauren C.
AU - Firestein, Morgan R.
AU - Kyle, Margaret H.
AU - Fields, Andrea
AU - Alcántara, Carmela
AU - Amso, Dima
AU - Austin, Judy
AU - Bain, Jennifer M.
AU - Barbosa, Jennifer
AU - Bence, Mary
AU - Bianco, Catherine
AU - Fernández, Cristina R.
AU - Goldman, Sylvie
AU - Gyamfi-Bannerman, Cynthia
AU - Hott, Violet
AU - Hu, Yunzhe
AU - Hussain, Maha
AU - Factor-Litvak, Pam
AU - Lucchini, Maristella
AU - Mandel, Arthur
AU - Marsh, Rachel
AU - McBrian, Danielle
AU - Mourad, Mirella
AU - Muhle, Rebecca
AU - Noble, Kimberly G.
AU - Penn, Anna A.
AU - Rodriguez, Cynthia
AU - Sania, Ayesha
AU - Silver, Wendy G.
AU - O'Reilly, Kally C.
AU - Stockwell, Melissa
AU - Tottenham, Nim
AU - Welch, Martha G.
AU - Zork, Noelia
AU - Fifer, William P.
AU - Monk, Catherine
AU - Dumitriu, Dani
N1 - Publisher Copyright:
© 2022 American Medical Association. All rights reserved.
PY - 2022/6
Y1 - 2022/6
N2 - Importance: Associations between in utero exposure to maternal SARS-CoV-2 infection and neurodevelopment are speculated, but currently unknown. Objective: 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. Design, Setting, and Participants: 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. Exposures: Maternal SARS-CoV-2 infection during pregnancy and birth during the COVID-19 pandemic. Main Outcomes and Measures: 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. Results: 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. Conclusions and Relevance: 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.
AB - Importance: Associations between in utero exposure to maternal SARS-CoV-2 infection and neurodevelopment are speculated, but currently unknown. Objective: 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. Design, Setting, and Participants: 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. Exposures: Maternal SARS-CoV-2 infection during pregnancy and birth during the COVID-19 pandemic. Main Outcomes and Measures: 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. Results: 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. Conclusions and Relevance: 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.
UR - http://www.scopus.com/inward/record.url?scp=85122348233&partnerID=8YFLogxK
U2 - 10.1001/jamapediatrics.2021.5563
DO - 10.1001/jamapediatrics.2021.5563
M3 - Article
C2 - 34982107
AN - SCOPUS:85122348233
SN - 2168-6203
VL - 176
SP - e215563
JO - JAMA Pediatrics
JF - JAMA Pediatrics
IS - 6
ER -