Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.
Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.
JAMA Pediatr. 2022 Jun 1;176(6):e215563. doi: 10.1001/jamapediatrics.2021.5563. Epub 2022 Jun 6.
Associations between in utero exposure to maternal SARS-CoV-2 infection and neurodevelopment are speculated, but currently unknown.
To examine the associations between maternal SARS-CoV-2 infection during pregnancy, being born during the COVID-19 pandemic regardless of maternal SARS-CoV-2 status, and neurodevelopment at age 6 months.
DESIGN, SETTING, AND PARTICIPANTS: A cohort of infants exposed to maternal SARS-CoV-2 infection during pregnancy and unexposed controls was enrolled in the COVID-19 Mother Baby Outcomes Initiative at Columbia University Irving Medical Center in New York City. All women who delivered at Columbia University Irving Medical Center with a SARS-CoV-2 infection during pregnancy were approached. Women with unexposed infants were approached based on similar gestational age at birth, date of birth, sex, and mode of delivery. Neurodevelopment was assessed using the Ages & Stages Questionnaire, 3rd Edition (ASQ-3) at age 6 months. A historical cohort of infants born before the pandemic who had completed the 6-month ASQ-3 were included in secondary analyses.
Maternal SARS-CoV-2 infection during pregnancy and birth during the COVID-19 pandemic.
Outcomes were scores on the 5 ASQ-3 subdomains, with the hypothesis that maternal SARS-CoV-2 infection during pregnancy would be associated with decrements in social and motor development at age 6 months.
Of 1706 women approached, 596 enrolled; 385 women were invited to a 6-month assessment, of whom 272 (70.6%) completed the ASQ-3. Data were available for 255 infants enrolled in the COVID-19 Mother Baby Outcomes Initiative (114 in utero exposed, 141 unexposed to SARS-CoV-2; median maternal age at delivery, 32.0 [IQR, 19.0-45.0] years). Data were also available from a historical cohort of 62 infants born before the pandemic. In utero exposure to maternal SARS-CoV-2 infection was not associated with significant differences on any ASQ-3 subdomain, regardless of infection timing or severity. However, compared with the historical cohort, infants born during the pandemic had significantly lower scores on gross motor (mean difference, -5.63; 95% CI, -8.75 to -2.51; F1,267 = 12.63; P<.005), fine motor (mean difference, -6.61; 95% CI, -10.00 to -3.21; F1,267 = 14.71; P < .005), and personal-social (mean difference, -3.71; 95% CI, -6.61 to -0.82; F1,267 = 6.37; P<.05) subdomains in fully adjusted models.
In this study, birth during the pandemic, but not in utero exposure to maternal SARS-CoV-2 infection, was associated with differences in neurodevelopment at age 6 months. These early findings support the need for long-term monitoring of children born during the COVID-19 pandemic.
人们推测，母亲在怀孕期间感染 SARS-CoV-2 与神经发育之间存在关联，但目前尚不清楚。
研究母亲在怀孕期间感染 SARS-CoV-2 与在 COVID-19 大流行期间出生（无论母亲 SARS-CoV-2 状态如何）以及 6 个月时神经发育之间的关联。
设计、设置和参与者：在纽约市哥伦比亚大学欧文医学中心的 COVID-19 母婴结局倡议中，招募了一组在怀孕期间暴露于母亲 SARS-CoV-2 感染的婴儿和未暴露的对照组。所有在哥伦比亚大学欧文医学中心分娩且在怀孕期间感染 SARS-CoV-2 的女性都被接触到。根据相似的出生胎龄、出生日期、性别和分娩方式，接触未暴露婴儿的女性也被接触到。在 6 个月大时使用第 3 版年龄与阶段问卷（ASQ-3）评估神经发育。还包括在大流行前出生且已完成 6 个月 ASQ-3 的历史队列中的婴儿。
母亲在怀孕期间感染 SARS-CoV-2 和在 COVID-19 大流行期间出生。
结果为 5 个 ASQ-3 子域的分数，假设母亲在怀孕期间感染 SARS-CoV-2 与 6 个月时的社会和运动发育下降有关。
在接触的 1706 名女性中，有 596 名参与；邀请了 385 名女性进行 6 个月评估，其中 272 名（70.6%）完成了 ASQ-3。在 COVID-19 母婴结局倡议中，有 255 名婴儿的数据可用（114 名在子宫内暴露，141 名未暴露于 SARS-CoV-2；中位母亲分娩年龄，32.0[IQR，19.0-45.0]岁）。还可以从大流行前出生的 62 名婴儿的历史队列中获得数据。子宫内暴露于母亲 SARS-CoV-2 感染与任何 ASQ-3 子域的显着差异无关，无论感染时间或严重程度如何。然而，与历史队列相比，在大流行期间出生的婴儿在粗大运动（平均差异，-5.63；95%CI，-8.75 至-2.51；F1,267=12.63；P<.005）、精细运动（平均差异，-6.61；95%CI，-10.00 至-3.21；F1,267=14.71；P<.005）和个人社交（平均差异，-3.71；95%CI，-6.61 至-0.82；F1,267=6.37；P<.05）子域的完全调整模型中得分较低。
在这项研究中，大流行期间出生而不是母亲在怀孕期间感染 SARS-CoV-2 与 6 个月时的神经发育差异有关。这些早期发现支持对在 COVID-19 大流行期间出生的儿童进行长期监测的必要性。
