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

Abstract

ObjectiveTo evaluate neuromotor repertoires and developmental milestones in infants exposed to antenatal COVID-19.DesignLongitudinal cohort study.SettingHospital-based study in Los Angeles, USA and Rio de Janeiro, Brazil between March 2020 and December 2021.ParticipantsInfants born to mothers with COVID-19 during pregnancy and prepandemic control infants from the Graz University Database.InterventionsGeneral 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 measuresMotor Optimality Scores Revised (MOS-R) at 3–5 months. Presence of developmental delay (DD) at 6–8 months.Results239 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).ConclusionsCompared with prepandemic controls, infants exposed to antenatal COVID-19 more frequently had suboptimal neuromotor development.

Use of Telehealth Methods to Track Infant Neurodevelopment After In Utero SARS-CoV-2 Exposure

“…In this cohort study, even though 18% of mothers had severe or critical COVID-19 illness, maternal symptom severity and timing of infection were not found to be associated with motor optimality scores. Because the study did not include a pandemic control group, it is not known whether motor optimality scores were associated solely with the SARS-CoV-2 exposure or with birth during the pandemic . In a similar observational study using parent-recorded videos of infants’ movements between ages 3 and 5 months, infants with antenatal SARS-CoV-2 exposure were found to have lower motor repertoire scores, including some infants who had an absence of fidgety movements that is concerning for the risk of future neurological conditions.…”

“…Because the study did not include a pandemic control group, it is not known whether motor optimality scores were associated solely with the SARS-CoV-2 exposure or with birth during the pandemic. 4 In a similar observational study using parent-recorded videos of infants' movements between ages 3 and 5 months, 5 infants with antenatal SARS-CoV-2 exposure were found to have lower motor repertoire scores, including some infants who had an absence of fidgety movements…”

“…General movement assessment is an observation-based assessment of infants that can be captured by a parent or caregiver on video, and it has been used in neurodevelopmental outcomes studies of children after antenatal SARS-CoV-2 exposure. In a study by Martinez et al 4 using general movement assessment videos in infants aged 3 to 5 months in the US and Brazil, the researchers found lower motor optimality scores in infants born to mothers with SARS-CoV-2 infection during pregnancy compared with infants in a prepandemic control group, which correlated with lower attainment of developmental milestones at ages 6 to 8 months. In this cohort study, 4 even though 18% of mothers had severe or critical COVID-19 illness, maternal symptom severity and timing of infection were not found to be associated with motor optimality scores.…”

“…In a study by Martinez et al 4 using general movement assessment videos in infants aged 3 to 5 months in the US and Brazil, the researchers found lower motor optimality scores in infants born to mothers with SARS-CoV-2 infection during pregnancy compared with infants in a prepandemic control group, which correlated with lower attainment of developmental milestones at ages 6 to 8 months. In this cohort study, 4 even though 18% of mothers had severe or critical COVID-19 illness, maternal symptom severity and timing of infection were not found to be associated with motor optimality scores. Because the study did not include a pandemic control group, it is not known whether motor optimality scores were associated solely with the SARS-CoV-2 exposure or with birth during the pandemic.…”

Poly(I:C)-induced maternal immune activation causes elevated self-grooming in male rat offspring: Involvement of abnormal postpartum static nursing in dam

“…No significant relationship was found between asymptomatic pregnant women and fetal growth restriction ( Narang et al, 2023 ). Fetuses born to SARS-CoV-2-infected women are more likely to suffer from neuromotor developmental disorders ( Fajardo Martinez et al, 2023 ). They also had lower scores in communication, problem solving and personal-social domains ( Cheng et al, 2021 ).…”