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Neuromotor repertoires in infants exposed to maternal COVID-19 during pregnancy: a cohort study

2023; BMJ; Volume: 13; Issue: 1 Linguagem: Inglês

10.1136/bmjopen-2022-069194

2044-6055

Viviana M. Fajardo, Dajie Zhang, Sophia Paiola, Thalia Mok, Mary Catherine Cambou, Tara Kerin, Rashmi Rao, Patrícia Brasil, Fátima Ferreira, Trevon Fuller, Debika Bhattacharya, Suan‐Sin Foo, Weiqiang Chen, Jae U. Jung, Christa Einspieler, Peter B. Marschik, Karin Nielsen‐Saines,

Neonatal and fetal brain pathology

Objective To evaluate neuromotor repertoires and developmental milestones in infants exposed to antenatal COVID-19. Design Longitudinal cohort study. Setting Hospital-based study in Los Angeles, USA and Rio de Janeiro, Brazil between March 2020 and December 2021. Participants Infants born to mothers with COVID-19 during pregnancy and prepandemic control infants from the Graz University Database. Interventions 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. Main outcome measures Motor Optimality Scores Revised (MOS-R) at 3–5 months. Presence of developmental delay (DD) at 6–8 months. Results 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). Conclusions Compared with prepandemic controls, infants exposed to antenatal COVID-19 more frequently had suboptimal neuromotor development.