summary: Babies of mothers who had mild or asymptomatic COVID-19 during pregnancy showed brain development similar to those born to mothers who did not contract COVID-19 during pregnancy.
source: Columbia University
Columbia researchers found that babies born to mothers with mild or asymptomatic COVID during pregnancy are normal, based on the results of a comprehensive assessment of brain development.
The findings expand on a smaller study that used mothers’ reports to assess the development of children born in New York City during the first wave of the pandemic. That study found no differences in brain development between children who were exposed to COVID in the womb and those who were not.
For the new study, the researchers developed a way to monitor the children remotely, and adapted an in-person growth assessment tool to make the study safe for coronavirus (the children were evaluated between March 2021 and June 2022).
Researchers studied 407 infants between 5 and 11 months of age from three geographic areas: New York City, Salt Lake City, Utah, and Birmingham, Alabama. Overall, nearly a third of babies are born to mothers who contracted COVID during pregnancy.
Prior to evaluation, each participating family received the same set of children’s toys and food items so that the researchers could monitor and compare the children’s fine and gross motor skills in a standardized manner. The researchers also assessed cognitive and language skills. They didn’t know which babies were exposed to COVID in the womb.
says study leader Danny Dumitriou, MD, PhD, assistant professor of pediatrics and psychiatry at Columbia University, Vagelos College of Physicians and Surgeons.
“But over time, we also realized that assessing children remotely would allow us to monitor how children are developing in their home environment, which may actually give a better idea of how children are developing than what we see in a research lab, where they may be fearful or anxious.”
Researchers found that babies whose mothers had mild or asymptomatic COVID-19 at any time during pregnancy developed similarly to those whose mothers did not have COVID.
“The current study, which used a more rigorous method for evaluating babies born during the pandemic, provides further reassuring evidence that having a mild or asymptomatic case of COVID during pregnancy does not affect brain development in infants,” Dumitriou says. “Additional studies are needed to tell us more severe impact of COVID on the developing infant brain.”
Funding: The study was funded by the US Centers for Disease Control and Prevention (75D30120C08150) and the National Institutes of Health (R01MH126531).
About this neurodevelopment and COVID-19 research news
author: Helen Gary
source: Columbia University
communication: Helen Jarry – Columbia University
picture: The image is in the public domain
Original search: open access.
“Evaluation of neurological development in infants with or without exposure to asymptomatic or mild SARS-CoV-2 infection during pregnancy” by Dani Dumitriu et al. JAMA Network is open
a summary
Assessment of neurological development in infected and unexposed infants with mild or asymptomatic SARS-CoV-2 infection during pregnancy
Importance
The association between prenatal exposure to SARS-CoV-2 and neurodevelopmental outcomes has significant public health relevance. A previous study found no association between prenatal SARS-CoV-2 infection and parent-reported infant neurodevelopmental outcomes, but standardized observational assessments are needed to confirm this finding.
objective
To assess whether mild or asymptomatic maternal SARS-CoV-2 infection versus no infection during pregnancy is associated with differences in neurodevelopment of 5- to 11-month-old infants.
Design, preparation and participants
This cohort study included infants of mothers from a single-site cross-sectional study (COVID-19 Mother Baby Outcomes). [COMBO] initiative) of mother-infant pairs and a prospective multisite cohort study (epidemiology of severe acute respiratory syndrome coronavirus 2 in pregnancy and infants) [ESPI]) of pregnant women. A subset of ESPI participants were subsequently enrolled in the ESPI COMBO substudy. Participants were enrolled in the ongoing COMBO study starting May 26, 2020; Participants were enrolled in the ESPI study from May 7 to November 3, 2021; and participants in the ESPI COMBO substudy were enrolled from August 2020 to March 2021. For the current analysis, the neurodevelopment of infants was assessed between March 2021 and June 2022. A total of 407 infants born to 403 mothers (204 from Columbia University Irving Medical Center in New York, NY; 167 from the University of Utah at Salt Lake City; and 36 from the University of Alabama at Birmingham). Mothers of unexposed infants were contacted based on the infants’ similar gestational age at birth, birth date, sex and mode of delivery to the exposed infants.
exposures
SARS-CoV-2 infection with or without symptoms in the mother.
Main findings and measures
The infants’ neurodevelopment was assessed using the Developmental Assessment of Young Children, Second Edition (DAYC-2), which has been adapted for telehealth assessment. The primary outcome was age-adjusted standardized scores on the 5 DAYC-2 subdomains: Perception, Gross Motor, Fine Motor, Expressive Language, and Receptive Language.
results
Among 403 mothers, the mean maternal age at birth was 32.1 (5.4) years; Most of the mothers were white (240 [59.6%]) and non-Hispanic ethnicity (253 [62.8%]). Of the 407 infants, 367 (90.2%) were born full term and 212 (52.1%) were male. Overall, 258 (63.4%) infants had no documented prenatal exposure to SARS-CoV-2 infection, 112 (27.5%) confirmed prenatal exposure, and 37 (9.1%) had preconception or unspecified exposure. In the adjusted models, maternal SARS-CoV-2 infection during pregnancy was not associated with differences in cognition (β = 0.31; 95% CI, −2.97 to 3.58), gross motor (β = 0.82; 95% CI, −1.34 to 2.99) , fine motor (β = 0.36; 95% CI, −0.74 to 1.47), expressive language (β = −1.00; 95% CI, −4.02 to 2.02), or receptive language (β = 0.45; 95% CI, −2.15 to 3.04) results for the DAYC-2 subdomain. Third trimester exposure and maternal symptomatic status were not associated with DAYC-2 subscale scores.
Conclusions and relevance
In this study, findings of a new observational neurodevelopmental assessment of telehealth monitoring expanded the previous finding of no association between prenatal exposure to maternal SARS-CoV-2 infection and infant neurodevelopment. Given the significant and ongoing spread of COVID-19, these data provide information that may be useful to pregnant individuals with mild or asymptomatic SARS-CoV-2 infection.