Developmental impairment in children exposed during pregnancy to maternal SARS-COV2: A Brazilian cohort study
Carolina A D Santos1, Artemis P Paula2, Gentil G Fonseca Filho3
1University of Campinas, UNICAMP, Faculty of Medical Science, Campinas, Brazil; Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil.
Insights
Maternal SARS-CoV-2 infection during pregnancy increased the risk of neurodevelopmental delay in infants. Early follow-up is crucial for these high-risk children to address potential long-term health effects.
Area of Science:
- Neuroscience
- Pediatrics
- Infectious Diseases
Background:
- Maternal SARS-CoV-2 infection during pregnancy is a growing concern.
- The impact of prenatal viral exposure on infant neurodevelopment requires further investigation.
Purpose of the Study:
- To assess the neurodevelopmental outcomes in infants exposed to SARS-CoV-2 in-utero.
- To compare neurodevelopment between SARS-CoV-2 exposed and unexposed infants.
Main Methods:
- Prospective cohort study in Brazil involving SARS-CoV-2 exposed (EG) and unexposed (CG) infants.
- Neurodevelopmental assessment using the Guide for Monitoring Child Development and Ages & Stages Questionnaire (ASQ-3).
- Follow-up conducted at multiple time points during the first year of life.
Main Results:
- Infants exposed to SARS-CoV-2 in-utero had a significantly higher risk of neurodevelopmental delay (3.44 times higher).
- Prevalence of neurodevelopmental delay was 20.3% in the exposed group versus 5.9% in the control group at 12 months.
- ASQ-3 revealed neurodevelopmental impairment in 35.7% at 4 months, 7% at 6 months, and 32.1% at 12 months in the exposed group.
Conclusions:
- In-utero SARS-CoV-2 exposure is associated with increased risk of neurodevelopmental impairment in infants.
- Specialized follow-up guidelines are necessary for high-risk infants exposed to SARS-CoV-2.
- Mitigating long-term effects on children's health requires targeted interventions.
Objectives:
To determine the effects of in-utero exposure to maternal SARS-CoV-2 infection on offspring's neurodevelopment during the first year of life.
Methods:
We performed a prospective cohort of babies exposed to SARS-CoV-2 during pregnancy, and a control group (CG) of unexposed babies in a low-income area in Brazil. Children's neurodevelopment was assessed using the guide for Monitoring Child Development in the Integrated Management of Childhood Illness context for both groups (at 1,2,3,4,5,6, 9, and 12 months), and the Ages & Stages Questionnaire (ASQ-3) for the exposed group (EG) (at 4, 6 and 12 months).
Results:
We followed 137 children for 1 year, 69 in the COVID-19-EG, and 68 in the CG. All mothers were unvaccinated at the time of cohort inclusion, and maternal demographics were similar in the two groups. 20.3% of EG children and 5.9% of the CG received a diagnosis of neurodevelopmental delay within 12 months of life (P = 0.013, relative risk = 3.44; 95% confidence interval, 1.19- 9.95). For the EG, the prevalence of neurodevelopment impairment using Ages & Stages Questionnaire was 35.7% at 4 months, 7% at 6 months, and 32.1% at 12 months.
Conclusion:
SARS-CoV-2 exposure was associated with neurodevelopmental impairment, and specific guidelines are needed for the follow-up of these high-risk children to mitigate the long-term effects on children's health.
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