COVID-19 during pregnancy surprisingly did not increase the chance of babies' neurodevelopmental delay, although those born during the pandemic were associated with higher neurodevelopmental delays compared to those born prior to the pandemic, according to a recent JAMA Pediatrics study.
Columbia University Irving Medical Center established a prospective cohort study called COVID-19 Mother Baby Outcomes (COMBO) Initiative in the spring of 2020 to study the associations between the exposure of the virus while the baby is still in the mother’s womb with the well-being of the baby.
The researchers studied a cohort of infants who were exposed to COVID-19 during pregnancy and compared them to a control group of similar gestational age at birth, birthday, sex, and mode of delivery who were not exposed to the virus.
"Infants born to mothers who have viral infections during pregnancy have a higher risk of neurodevelopmental deficits, so we thought we would find some changes in the neurodevelopment of babies whose mothers had COVID during pregnancy," said lead investigator Dr. Dani Dumitriu.
"We were surprised to find absolutely no signal suggesting that exposure to COVID while in utero was linked to neurodevelopmental deficits. Rather, being in the womb of a mother experiencing the pandemic was associated with slightly lower scores in areas such as motor and social skills," added Dumitriu, who is a Columbia University assistant professor of pediatrics and psychiatry.
The researchers studied 255 babies born during the pandemic in 2020, 45% who were exposed to the virus (meaning the mother had been infected during pregnancy), comparing child developmental scores among these babies with 62 who were delivered prior to the pandemic (so not exposed to the virus).
The study found babies born during the 2020 pandemic, regardless if they were exposed to the virus during pregnancy or not, scored lower in gross motor skills, fine motor skills, and problem-solving compared to those born prior to the pandemic.
The study has several limitations, including it was performed at a single site in New York City when COVID-19 was the epicenter at the time (so this makes it difficult to generalize), it only studied development patterns up to 6 months and the assessments of the neurodevelopment of the babies were subjective, not objective, because they were parent-reported.
It is well established that viral illness during pregnancy can increase the risk of neurodevelopmental delays by activating the immune system, which in turn influences the development of the brain, according to a recent report.
And other studies have shown that COVID-19 is associated with health and birth complications for pregnant women, including one published last October which showed babies born to pregnant mothers with COVID-19 had a higher risk for poor fetal growth and low birth weight, partly because of the increased risk for preterm delivery, the report added.
"With potentially millions of infants who may have been exposed to COVID in utero, and even more mothers just living through the stress of the pandemic, there is a critical need to understand the neurodevelopmental effects of the pandemic on future generations," Dumitriu said.