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Effects of SARS-CoV-2 gestational exposure and risk factors on neurodevelopment until 12 months: A prospective cohort
Gabriela Soutto Mayor Assumpção Pinheiro1, Stela Maris Aguiar Lemos1, Isadora de Araújo Martins1
1Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil.
Insights
Gestational exposure to SARS-CoV-2 did not increase developmental delay risk. However, earlier exposure, particularly in the first trimester, correlated with higher risk at 12 months.
Area of Science:
- Pediatric Neurodevelopment
- Infectious Disease Epidemiology
- Maternal-Fetal Health
Background:
- The impact of SARS-CoV-2 infection during pregnancy on child neurodevelopment is not well-established.
- Previous studies have yielded inconclusive results regarding developmental outcomes in children exposed to the virus in utero.
- Understanding these effects is crucial for public health guidance and pediatric care.
Purpose of the Study:
- To investigate the association between gestational SARS-CoV-2 exposure and neurodevelopmental outcomes in infants up to 12 months of age.
- To identify specific risk factors contributing to developmental delays in this cohort.
- To analyze the influence of the timing of gestational exposure on neurodevelopment.
Main Methods:
- A prospective cohort study was conducted in Southeast Brazil, including 224 SARS-CoV-2 exposed and 225 non-exposed infants.
- Infant neurodevelopment was assessed at 6 and 12 months using the Survey of Wellbeing of Young Children-Brazilian Version (SWYC-BR).
- Suspected developmental delay (SDD) and high risk for developmental delay (HRDD) were primary outcome measures, with risk factor analysis performed.
Main Results:
- No overall association was found between gestational SARS-CoV-2 exposure and suspected developmental delay (SDD).
- Exposure during the first trimester of pregnancy was linked to a 2.15-fold increased risk of SDD compared to third-trimester exposure.
- Cesarean delivery (OR 1.56) and suspected maternal depression (OR 1.76) were significant predictors of SDD, independent of viral exposure.
Conclusions:
- Gestational SARS-CoV-2 exposure does not appear to elevate the overall risk of developmental delay in infants by 12 months.
- The timing of gestational exposure is critical, with earlier exposure correlating with increased risk.
- Cesarean delivery and maternal depression are independent risk factors for developmental delay, underscoring the need for comprehensive maternal and infant care.
Background:
The effects of SARS-CoV-2 gestational exposure on child development remain inconclusive.
Aims:
To analyze the effects of SARS-CoV-2 gestational exposure on neurodevelopment until 12 months.
Study Design:
Prospective cohort study conducted in five municipalities in Southeast Brazil from August 2021 to September 2022.
Subjects:
Infants were recruited from a serological survey performed during neonatal screening and followed up to 12 months old. We included 224 infants exposed to SARS-CoV-2 during pregnancy and 225 non-exposed, according to the serology results of the newborn as well as their mothers and the maternal antenatal RT-PCR results.
Outcome Measures:
Developmental assessments were performed at 6 and 12 months using the Survey of Wellbeing of Young Children-Brazilian Version (SWYC-BR). Children with suspected developmental delay (SDD) at 6 and 12 months were considered at high risk for developmental delay (HRDD). Additionally, risk factors associated with SDD were examined.
Results:
There were 111 children identified with SDD and 52 with HRDD. SARS-CoV-2 gestational exposure was not associated with SDD. Exposure in the first gestational trimester increased SDD risk by 2.15 times compared to the third. Cesarean delivery predicted SDD (OR 1.56; 95%CI 1.01-2.42) and HRDD (OR 1.91; 95%CI 1.04-3.48). Additionally, suspected maternal depression predicted SDD (OR 1.76; 95%CI 1.01-3.10).
Conclusion:
SARS-CoV-2 gestational exposure did not increase the developmental delay risk. However, our findings suggest that the earlier the gestational exposure, the greater the developmental delay risk at 12 months. Cesarean delivery and suspected maternal depression increased the developmental delay risk, independent of virus exposure.
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