Neurodevelopment in infants with antenatal or early neonatal exposure to SARS-CoV-2

Authors

Sarah B. Mulkey, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, United States; Department of Neurology, The George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20037, United States; Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20037, United States. Electronic address: SBMULKEY@childrensnational.org.
Meagan E. Williams, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, United States.
Nadia Jadeed, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, United States.
Anqing Zhang, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, United States.
Smitha Israel, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, United States.
Roberta L. DeBiasi, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, United States; Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20037, United States; Department of Microbiology, Immunology and Tropical Medicine, The George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20037, United States.

Document Type

Journal Article

Publication Date

12-1-2022

Journal

Early human development

Volume

175

DOI

10.1016/j.earlhumdev.2022.105694

Keywords

Ages and Stages Questionnaire; COVID-19; Congenital infection; Developmental screening; Infant development; Pregnancy

Abstract

BACKGROUND: Antenatal and neonatal viral exposure may put the developing brain at risk for abnormal neurodevelopment. A clinical program at Children's National Hospital provides detailed follow-up of infants with in utero or neonatal SARS-CoV-2 exposure. AIMS: To determine impact of early SARS-CoV-2 exposure on neurodevelopment. STUDY DESIGN: We performed a prospective observational study of infant evaluations between 3/2020 and 11/2021. Demographics, pregnancy and birth details, SARS-CoV-2 data, specialty consultations, and NICU records were extracted from infants' medical records. Infants had neurologic exams and developmental screening with Ages and Stages Questionnaire (ASQ). Correlations between SARS-CoV-2 exposure type and neurodevelopmental outcomes were analyzed. SUBJECTS: Thirty-four infants evaluated in the SARS-CoV-2 follow-up program. OUTCOME MEASURES: Abnormal neurologic exams or ASQ scores near or below suggested cut-offs. RESULTS: Infants received up to three evaluations. Most (28/34; 82 %) were exposed in utero - 16 to symptomatic mothers (IU-S) and 12 to asymptomatic mothers (IU-A). Six were exposed only as a neonate. IU-S had abnormal neurologic exams at mean (SD) age 112 (24) days and ASQ scores near or below cut-offs for all domains more frequently than IU-A or neonatally exposed infants. IU-S were more likely to score below any ASQ cutoff compared to IU-A (P = .04); differences were significant for Fine Motor (P = .01) and Personal-Social (P = .02) domains. CONCLUSIONS: Early SARS-CoV-2 exposure may impact neurodevelopment, especially among infants exposed in utero to symptomatic gestational parents. Vaccination and other precautions to reduce early-in-life infection may protect against neurodevelopmental delays. Children with early SARS-CoV-2 exposure should have additional longitudinal screening for neurodevelopmental delays.

APA Citation

Mulkey, Sarah B.; Williams, Meagan E.; Jadeed, Nadia; Zhang, Anqing; Israel, Smitha; and DeBiasi, Roberta L., "Neurodevelopment in infants with antenatal or early neonatal exposure to SARS-CoV-2" (2022). GW Authored Works. Paper 2178.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2178

Department

Pediatrics