Neurodevelopmental delay in children exposed to maternal SARS-CoV-2…

Research question

Is SARS-CoV-2 infection during pregnancy associated with adverse neurodevelopment in the children?

Clinical & scientific significance

The authors conclude that children exposed to COVID-19 before birth should be offered neurodevelopmental follow-up.

Key findings reported in the paper

Overall, 20 of 172 exposed children (11.6%) and 2 of 128 controls (1.6%) had developmental delay (p = 0.0006).
On Bayley-III alone: 12 of 128 exposed (9.4%) vs 2 of 128 controls (1.6%), p = 0.0007; 8 of 44 additional exposed children had delay on ASQ-3.
Rio de Janeiro: 12% vs 2.6% (p = 0.02). Los Angeles: 5.7% vs 0% (p = 0.12, not statistically significant).
Severe or critical maternal COVID-19 predicted below-average neurodevelopment (OR 2.6, 95% CI 1.1–6.4).

Developmental delay (Bayley-III or ASQ-3)

Developmental delay (Bayley-III or ASQ-3)
Exposed in utero	11.6% (20 / 172)
Pre-pandemic controls	1.6% (2 / 128)

p = 0.0006. Values as reported in the abstract. Data as reported in the publication abstract.

children assessed in two countries: 300
severe/critical maternal COVID-19 and below-average development: OR 2.6

Objectives

To compare neurodevelopmental outcomes of in utero-exposed children with pre-pandemic control children in Los Angeles and Rio de Janeiro.

Methods

300 children were tested: 172 exposed (5–30 months; born April 2020–December 2022) and 128 controls (6–38 months; born 2016–2019), using the Bayley-III and the ASQ-3. Developmental delay was defined by a Bayley-III domain score < 70 or an ASQ-3 domain score below the cut-off.

This summary is based only on the published abstract.

How infant neurodevelopment is assessed in these studies

01
3–5 months
Video recording of spontaneous movements scored with the Motor Optimality Score-Revised (MOS-R).
02
6–8 months
Clinical assessment of developmental milestones.
03
Bayley-III
Cognitive, motor and language domains; delay defined as a score below 70.
04
ASQ-3
Parent questionnaire across five domains; delay = score below the cut-off.

Assessment tools and ages as reported in the cohort publications (BMJ Open 2023; Scientific Reports 2024). Conceptual illustration — not experimental data.

Read the publication

Free full text (PMC): PMC11126599 (opens in a new tab)

COVID-19 in pregnancyInfant neurodevelopment

Authors

Fajardo-Martinez V, Ferreira F, Fuller T, Cambou MC, Kerin T, Paiola S, Mok T, Rao R, Mohole J, Paravastu R, Zhang D, Marschik P, Iyer S, Kesavan K, Borges Lopes MDC, Britto JAA, Moreira ME, Brasil P, Nielsen-Saines K

Citation

Neurodevelopmental delay in children exposed to maternal SARS-CoV-2 in-utero. Sci Rep. 2024; 14(1):11851. doi:10.1038/s41598-024-61918-2. PMID: 38789553.

Neurodevelopmental delay in children exposed to maternal SARS-CoV-2 in-utero