06 Jan COVID-19: Neurodevelopment Effects on Infants Exposed in Utero
MedicalResearch.com Interview with:
Dr. Dumitriu
Dani Dumitriu, MD, PhD
Assistant Professor of Pediatrics (in Psychiatry)
The Sackler Institute for Developmental Psychobiology
Columbia University, New York
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A lot of research has focused on the effects of COVID-19 in various vulnerable populations, such as elderly individuals, immunocompromised patients, and individuals with severe comorbidities. However, one vulnerable population that has remained relatively understudied are the infants exposed to maternal COVID-19 disease during pregnancy.
While early on in the pandemic we and other groups showed reassuring data on low risk of vertical transmission, meaning the passing of the virus from mother-to-infant is rare, this does not necessarily mean that these infants wouldn’t experience long-term consequences related to the maternal infection through other means. We know from other viral illness that maternal illness, most commonly through the activation of her immune system, can lead to a cascade of events that affect fetal development. This is why a large number of physicians and researchers at Columbia University spearheaded the COVID-19 Mother Baby Outcomes (COMBO) Initiative — to look at potential long-term health effects on both infants and mothers.
Given data from other viral illnesses during pregnancy, we expected to see a negative impact on the development of infants who had been exposed to maternal COVID-19 disease in pregnancy. However, to our surprise, we saw absolutely no effect of maternal infection with SARS-CoV-2 on infant neurodevelopment at 6 months assessed through a standard pediatric screening test called the ASQ-3. Thanks to our large COMBO team, we were fortunate that co-first author Dr. Lauren Shuffrey had used the same screening tool at age 6 months in a different study of babies born at our hospital in the three years prior to the pandemic. Dr. Shuffrey and co-first author Dr. Morgan Firestein could therefore compare our cohort of infants born during the pandemic to this historical cohort, and when we did, we found that infants born during the pandemic, irrespective of maternal infection, scored slightly lower on motor and social skills. Their scores were not dramatically different and in our sample of a few hundred infants this did not translate to an overall higher proportion of infants that “failed” this screening test, but these differences nevertheless warrant careful attention give the prevalence of this disease.
MedicalResearch.com: What should readers take away from your report?
Response: The scientific and medical communities have mostly speculated that infants born to mothers who contract COVID-19 during pregnancy might show neurodevelopmental decrements. This translates to potential impact on millions of children born worldwide over the last two years. Our study, however, points to potential impact on the neurodevelopment of infants born during the pandemic irrespective of maternal infection, which – if replicated – would translate to potential impact on hundreds of millions of children born since the onset of the pandemic, with potential for significant public health consequences.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: We have a duty to continue to monitor the infants born during the pandemic. Our study highlights that we need to study these infants broadly, not only those exposed to the virus either in utero or after birth. We also need to now begin to investigate the mechanisms that contribute to the observed neurodevelopmental decrements, including maternal pre- and postnatal stress, changes in healthcare delivery and access, and worldwide socioeconomic changes.
MedicalResearch.com: Is there anything else you would like to add?
Response: It is important to note that our study does not necessarily mean that these infants will suffer long-term consequences.
Firstly, the effects we saw were small.
Secondly, this is still a very early developmental timepoint and because lots happens in the first few years of life, scores on an assessment at 6 months are poor predictors of long-term outcomes.
Thirdly, and most importantly, if our findings replicate and birth during the pandemic indeed negatively impacts neurodevelopment, because this is such an early timepoint there are lots of opportunities to intervene and get these babies onto the right developmental trajectory.
The brains of 6-month-old infants are very plastic, very malleable, so by talking, singing, playing, and interacting with them and finding safe ways to take them out of the home more often, parents can absolutely help mitigate potential issues down the road.
The authors report no conflicts of interest related to this study. A full list of disclosure is included in the article.
Citation:
Shuffrey LC, Firestein MR, Kyle MH, et al. Association of Birth During the COVID-19 Pandemic With Neurodevelopmental Status at 6 Months in Infants With and Without In Utero Exposure to Maternal SARS-CoV-2 Infection. JAMA Pediatr. Published online January 04, 2022. doi:10.1001/jamapediatrics.2021.5563
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Last Updated on January 6, 2022 by Marie Benz MD FAAD