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Developmental outcomes in infants treated with therapeutic hypothermia before and during the COVID-19 pandemic

Sriya Roychaudhuri1,2, Gabriel Côté-Corriveau1,3, Hoda Elshibiny1

  • 1Division of Newborn Medicine, Department of Pediatrics, Mass General Brigham for Children, Boston, MA, USA.

Pediatric Research
|July 7, 2026
PubMed

Insights

Infants born during the COVID-19 pandemic showed poorer language and motor skills compared to pre-pandemic peers. This highlights the need for resilient support systems for high-risk infants during crises.

Area of Science:

  • Neonatal neurology and developmental pediatrics.
  • Impact of global health crises on child development.
  • Neurodevelopmental outcomes and early intervention.

Background:

  • Infants with hypoxic-ischemic encephalopathy (HIE) face high risks for adverse neurodevelopmental outcomes.
  • The COVID-19 pandemic disrupted healthcare and social systems, potentially exacerbating risks for vulnerable infants.
  • Understanding pandemic-related impacts on HIE outcomes is crucial for targeted support.

Purpose of the Study:

  • To compare neurodevelopmental outcomes of infants with HIE born before the COVID-19 pandemic versus during the pandemic.
  • To assess the influence of pandemic-related disruptions on language and motor development in high-risk neonates.
  • To identify disparities in outcomes based on family-social risk during the pandemic.

Main Methods:

  • Retrospective cohort study comparing infants with HIE born pre-pandemic (Oct 2017–Dec 2019) and during the pandemic (Mar 2020–Sep 2021).
  • Neurodevelopmental assessments using the Bayley Scales of Infant Development-4 at 12 and 18–24 months.
  • Analysis of baseline characteristics, language scores, and gross motor development between the two cohorts.

Main Results:

  • No significant differences in baseline characteristics between pre-pandemic and pandemic cohorts (n=33 vs n=40).
  • Infants born during the pandemic exhibited lower language scores at 12 months (mean 93.3 vs 99.4, p=0.042).
  • Poorer gross motor development was more prevalent in the pandemic cohort at 12 months (40.6% vs 9.1%, p=0.014) and 18–24 months (45.5% vs 18.5%, p=0.035).
  • The disparity in language performance widened between infants with low and high family-social risk during the pandemic.

Conclusions:

  • Infants with HIE born during the pandemic experienced temporary language deficits and persistent motor impairments compared to their pre-pandemic counterparts.
  • These outcomes may stem from reduced access to therapies and increased family stress during the pandemic.
  • Strengthening resilient and equitable follow-up support systems is essential for vulnerable children during periods of societal disruption.
  • Findings underscore the need for robust healthcare preparedness and policies to ensure equitable care for high-risk neonates during public health crises.
Abstract

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