Pediatrics, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA.
Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen and Leibniz-ScienceCampus Primate Cognition, Göttingen, Germany.
BMJ Open. 2023 Jan 23;13(1):e069194. doi: 10.1136/bmjopen-2022-069194.
To evaluate neuromotor repertoires and developmental milestones in infants exposed to antenatal COVID-19.
Longitudinal cohort study.
Hospital-based study in Los Angeles, USA and Rio de Janeiro, Brazil between March 2020 and December 2021.
Infants born to mothers with COVID-19 during pregnancy and prepandemic control infants from the Graz University Database.
General movement assessment (GMA) videos between 3 and 5 months post-term age were collected and clinical assessments/developmental milestones evaluated at 6-8 months of age. Cases were matched by gestational age, gender and post-term age to prepandemic neurotypical unexposed controls from the database.
Motor Optimality Scores Revised (MOS-R) at 3-5 months. Presence of developmental delay (DD) at 6-8 months.
239 infants were enrolled; 124 cases (83 in the USA/41 in Brazil) and 115 controls. GMA was assessed in 115 cases and 115 controls; 25% were preterm. Median MOS-R in cases was 23 (IQR 21-24, range 9-28) vs 25 (IQR 24-26, range 20-28) in controls, p<0.001. Sixteen infants (14%) had MOS-R scores <20 vs zero controls, p<0.001. At 6-8 months, 13 of 109 case infants (12%) failed to attain developmental milestones; all 115 control infants had normal development. The timing of maternal infection in pregnancy (first, second or third trimester) or COVID-19 disease severity (NIH categories asymptomatic, mild/moderate or severe/critical) was not associated with suboptimal MOS-R or DD. Maternal fever in pregnancy was associated with DD (OR 3.7; 95% CI 1.12 to 12.60) but not suboptimal MOS-R (OR 0.25; 95% CI 0.04 to 0.96).
Compared with prepandemic controls, infants exposed to antenatal COVID-19 more frequently had suboptimal neuromotor development.
评估产前感染 COVID-19 的婴儿的神经运动表现和发育里程碑。
纵向队列研究。
美国洛杉矶和巴西里约热内卢的医院。
母亲在孕期感染 COVID-19 的婴儿和 Graz 大学数据库中产前无 COVID-19 的对照婴儿。
收集出生后 3 至 5 个月的一般运动评估（GMA）视频，并在 6 至 8 个月时进行临床评估/发育里程碑评估。病例通过孕龄、性别和校正胎龄与数据库中无 COVID-19 的产前神经发育正常对照相匹配。
3 至 5 个月时修订后的运动优化评分（MOS-R）。6 至 8 个月时存在发育迟缓（DD）。
共纳入 239 例婴儿，其中 124 例病例（美国 83 例，巴西 41 例）和 115 例对照。115 例病例和 115 例对照进行了 GMA 评估；25%为早产儿。病例的中位 MOS-R 为 23（IQR 21-24，范围 9-28），对照组为 25（IQR 24-26，范围 20-28），p<0.001。16 例婴儿（14%）MOS-R 评分<20，而对照组为零，p<0.001。在 6 至 8 个月时，109 例病例婴儿中有 13 例（12%）未能达到发育里程碑，而所有 115 例对照婴儿发育正常。妊娠时母亲感染的时间（妊娠早期、中期或晚期）或 COVID-19 疾病的严重程度（NIH 分类无症状、轻度/中度或重度/危重）与 MOS-R 评分不理想或 DD 无关。妊娠时母亲发热与 DD 相关（OR 3.7；95%CI 1.12 至 12.60），但与 MOS-R 评分不理想无关（OR 0.25；95%CI 0.04 至 0.96）。
与产前无 COVID-19 对照相比，产前感染 COVID-19 的婴儿神经运动发育不良更为常见。
