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Neurodevelopment in infants with antenatal or early neonatal exposure to SARS-CoV-2

Sarah B Mulkey1, Meagan E Williams2, Nadia Jadeed2

  • 1Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, United States; Department of Neurology, The George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20037, United States; Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20037, United States.

Early Human Development
|November 19, 2022
PubMed

Insights

Infants exposed to SARS-CoV-2 in utero, particularly from symptomatic mothers, showed more frequent neurodevelopmental delays. Early screening is crucial for these infants to monitor and address potential delays.

Area of Science:

  • Pediatric Neurology
  • Developmental Pediatrics
  • Infectious Diseases

Background:

  • Prenatal and neonatal viral infections pose risks to infant brain development.
  • A specialized program at Children's National Hospital tracks infants with SARS-CoV-2 exposure.

Purpose of the Study:

  • To assess the neurodevelopmental impact of early SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) exposure in infants.
  • To identify specific risks associated with different exposure types (in utero vs. neonatal).

Main Methods:

  • Prospective observational study of 34 infants evaluated between March 2020 and November 2021.
  • Data collected included demographics, maternal health, SARS-CoV-2 status, and neonatal intensive care unit (NICU) records.
  • Infants underwent neurologic examinations and developmental screening using the Ages and Stages Questionnaire (ASQ).

Main Results:

  • Most infants (82%) had in utero exposure, with 16 from symptomatic mothers (IU-S) and 12 from asymptomatic mothers (IU-A).
  • IU-S infants exhibited more frequent abnormal neurologic exams and ASQ scores below cut-offs compared to IU-A and neonatally exposed infants.
  • Significant differences were observed in Fine Motor (P=.01) and Personal-Social (P=.02) domains for IU-S infants compared to IU-A.

Conclusions:

  • Early SARS-CoV-2 exposure, especially in utero to symptomatic mothers, may negatively affect infant neurodevelopment.
  • Preventing early-life infections through vaccination and precautions is vital for protecting against neurodevelopmental delays.
  • Infants with early SARS-CoV-2 exposure require ongoing neurodevelopmental screening and monitoring.
Abstract

Keywords:
Ages and Stages QuestionnaireCOVID-19Congenital infectionDevelopmental screeningInfant developmentPregnancy

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