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 - Funding Information:
Dr Gyamfi-Bannerman reported receiving fees for lectures from Medela and Hologic outside the submitted work. Dr Stockwell reported receiving grants from the Centers for Disease Control and Prevention for SARS-CoV-2 surveillance-related projects outside the submitted work. Dr Welch reported receiving gift funds from Einhorn Collaborative, Mary Dexter Stephenson, and Fleur Fairman Family during the conduct of the study. Dr Fifer reported receiving grants from the National Institutes of Health during the conduct of the study. Dr Monk reported receiving grants from the National Institute of Mental Health during the conduct of the study. Dr Dumitriu reported receiving grants from the National Institute of Mental Health and the Centers for Disease Control and Prevention during the conduct of the study and personal fees for lectures and round-table discussions from Medela outside the submitted work. No other disclosures were reported.
Funding Information:
cohort was supported by the Rita G. Rudel Foundation and by grant K99HD103910 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (Dr Shuffrey). Data collection for the COMBO study was supported by grant R01MH126531 from National Institute of Mental Health (Drs Marsh, Monk, and Dumitriu), grant P2CHD058486 from Eunice Kennedy Shriver National Institute of Child Health and Human Development awarded to the Columbia Population Research Center at Columbia University, and an award from the Society for Research in Child Development (Dr Firestein).
Funding Information:
Additional Contributions: We are grateful for the institutional support provided by the Maternal-Child Research Oversight (MaCRO) Committee and the Departments of Pediatrics, Psychiatry, and Obstetrics and Gynecology at Columbia University Irving Medical Center, which made possible the collection of time-sensitive information at the height of the COVID-19 pandemic before the availability of external funding opportunities. We thank the entire COVID-19 Mother Baby Outcomes (COMBO) Initiative team for their collaborative and persevering contributions during uncertain times. In addition, we extend particular gratitude toward the families enrolled in COMBO, whose participation continues to inform our understanding of this unprecedented global event.
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 -