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BREAKING! Children Whose Mothers Were Infected With COVID-19 During Pregnancy Likely to Suffer from Neurodevelopmental Delays!
Nikhil Prasad Fact checked by:Thailand Medical News Team May 27, 2024 5 months, 3 weeks, 4 days, 15 minutes ago
COVID-19 News: A recent study conducted by the UCLA School of Medicine, Universidade do Rio de Janeiro, and Fundação Oswaldo Cruz (Fiocruz) that is covered in this COVID-19 News report has revealed that children born to mothers who were infected with COVID-19 during pregnancy are at a higher risk of neurodevelopmental delays. This groundbreaking research assessed pediatric neurodevelopmental outcomes in children whose mothers had laboratory-confirmed SARS-CoV-2 infection during pregnancy. The study compared these outcomes to those of children born before the pandemic in Los Angeles, USA, and Rio de Janeiro, Brazil. The findings suggest significant developmental challenges for children exposed to the virus in utero.
Children Whose Mothers Were Infected With COVID-19 During Pregnancy Likely to Suffer from Neurodevelopmental Delays
ThailandMedical News had also covered a previous study by researchers from Harvard that also found that babies born to COVID-19 infected mothers also had neurodevelopmental disorders.
Assessing Neurodevelopmental Outcomes
To evaluate the neurodevelopmental outcomes, the researchers employed two primary tools: the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) and the Ages and Stages Questionnaires (ASQ-3). The Bayley-III is considered the gold standard for assessing neurodevelopment up to 36 months of age, while the ASQ-3 is a commonly used screening instrument for the same age group. Developmental delay (DD) was defined as scoring below −2 standard deviations from the norm (<70) in at least one of the Bayley-III domains (cognitive, motor, or language) or below the cut-off in at least one of the ASQ-3 domains (communication, gross motor, fine motor, problem-solving, personal-social).
Participants
The study included a total of 300 children: 172 COVID-19 exposed children aged 5 - 30 months and 128 control children aged 6–38 months. The exposed children were born between April 2020 and December 2022, while the control children were born between January 2016 and December 2019. Neurodevelopmental testing revealed that 12 out of 128 exposed children (9.4%) had developmental delays, compared to only 2 out of 128 control children (1.6%).
Results
In Rio, 12% of exposed children showed developmental delays, compared to 2.6% of controls. In Los Angeles, 5.7% of exposed children had developmental delays, with no delays observed in the control group.
Prevalence of Developmental Delays
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Bayley-III median composite scores for cognitive, language, and motor domains showed significant differences between exposed and control children. In Los Angeles, the cognitive scores were significantly lower in exposed children (110 vs. 120). In Rio, the language domain scores were lower in exposed children (83 vs. 89). The overall prevalence of developmental delays was higher in the COVID-19 cohort, with 12% of exposed children in Rio and 5.7% in Los Angeles showing delays, primarily in the language domain.
Predictors of Developmental Delays
The study identified several predictors of developmental delays in children exposed to maternal COVID-19. Severe or critical maternal COVID-19 significantly predicted below-average neurodevelopment (OR 2.6, 95% CI 1.1–6.4). Preterm delivery also showed a trend towards significance but did not reach it as a predictor of below-average performance.
Implications of Findings
The findings suggest a higher frequency of developmental delays in children exposed to maternal COVID-19 during pregnancy. Previous research has linked maternal immune activation (MIA) due to respiratory infections during pregnancy with higher risks of neurodevelopmental and neuropsychiatric conditions in offspring. The study hypothesizes that MIA may create a hostile in utero environment, adversely affecting infant neurodevelopment.
Comparison with Previous Studies
Earlier studies have also reported higher neurodevelopmental risks among children born to mothers with COVID-19. For instance, a large series evaluating ICD-10 diagnostic codes found a greater frequency of neurodevelopmental diagnoses in children exposed to SARS-CoV-2 during pregnancy. Another study indicated a higher risk of neurodevelopmental diagnoses in male infants at 12 months of age.
Use of Bayley-III and ASQ-3
This study is the first to use the Bayley-III as the primary neurodevelopmental tool to assess children with antenatal SARS-CoV-2 exposure. While ASQ-3 is a validated screening tool, Bayley-III provides more specific assessments of developmental delays. The study found comparable results for both assessments, suggesting that ASQ-3 can adequately predict developmental outcomes.
Impact of Pandemic Conditions
The study also considers the impact of pandemic conditions, such as lockdowns and lack of interaction between parents and children, on neurodevelopmental outcomes. The findings indicate that social and economic factors play a significant role in infant neurodevelopment. However, severe developmental delays observed in the study are unlikely to be solely due to these factors.
Conclusion
The study concludes that children exposed to maternal COVID-19 during pregnancy have a significantly higher frequency of developmental delays compared to non-exposed controls. Severe maternal COVID-19 is a predictor of below-average neurodevelopmental performance. The researchers recommend long-term neurodevelopmental follow-up for children exposed to antenatal COVID-19 and further investigation into the mechanistic pathways leading to developmental delays. Understanding these pathways could help mitigate the adverse effects of maternal COVID-19 on child development.