As the world marks 2 ½ years of a long, hard slog through the global COVID-19 pandemic, a new study was just released in the Journal of the American Medical Association (JAMA) that may create potential concern for pregnant and new families.  Neurodevelopmental Outcomes at 1 Year in Infants of Mothers Who Tested Positive for SARS-CoV-2 During Pregnancy indicates a relationship between neurodevelopmental delays on 12 month old impacts and the COVID status of the parent during pregnancy.  Infants were diagnosed at 12 months with neurodevelopmental delays at higher rates if they were exposed to COVID in utero.

The COVID-19 situation is relatively new, therefore, published research on the impact of the virus on pregnancy and newborns is nascent.  The short and long-term effects of this virus are not understood and the authors acknowledge that more research is needed.

How was this study conducted

Using electronic health records, this study tracked 7772 infants born to families in the Boston, Massachusetts area from March through December, 2020.  Of that group, 222 parents had been diagnosed with COVID during their pregnancies. 14 of 222 exposed infants (6.3%), and 227 of 7550 unexposed infants (3.0%) received a neurodevelopmental diagnosis within 12 months of age.  

What did this study find

The researchers stated that they

“observed neurodevelopmental diagnoses to be significantly more common among exposed offspring, particularly those exposed to third-trimester maternal infection. The majority of these diagnoses reflected developmental disorders of motor function or speech and language.”

Study limitations

Researchers acknowledged that there were limitations to the study, including the short length of time of this longitudinal study.  It should also be noted that most neurodevelopmental delays are not typically diagnosed at 12 months of age.  There may be additional biases in that parents infected with COVID during pregnancy may have had more concern and been more inclined to seek out developmental assessments on their infant than those who were not ill.  Further research will benefit from a larger sample size.

Study conclusions

The researchers preliminary findings are suggestive of an increased risk of adverse neurodevelopmental outcomes by 12 months of age for infants exposed to COVID prenatally.  There is an opportunity to use electronic health records of parents who were sick with COVID during their pregnancies in a retrospective study that could identify risks for infants, before the ability to conduct large-scale prospective studies presents itself.  

Applications for childbirth educators

Childbirth educators and other perinatal professionals should be aware of this study and be prepared to respond if expectant families ask about these findings.  Families who are pregnant should be encouraged to follow Centers for Disease Control vaccination recommendations and take caution to minimize potential exposures.  If they are diagnosed with COVID during pregnancy, consulting with their infant’s health care provider to implement any appropriate screenings that may be helpful to identify issues and initiate early intervention if needed.

References

Edlow AG, Castro VM, Shook LL, Kaimal AJ, Perlis RH. Neurodevelopmental Outcomes at 1 Year in Infants of Mothers Who Tested Positive for SARS-CoV-2 During Pregnancy. JAMA Netw Open. 2022;5(6):e2215787. doi:10.1001/jamanetworkopen.2022.15787

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