Does Prenatal Exposure to the SARS-CoV-2 Infection Impact Child Neurodevelopment?

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Records have shown that being exposed to viral infections during pregnancy—including the flu and severe acute respiratory syndrome—is linked to “adverse neurodevelopmental outcomes” in children, which could include lower educational achievement and IQ scores, along with a rise in risk for neurodevelopmental and neuropsychiatric disorders.¹

Keeping this in mind, when the COVID-19 pandemic hit, pregnant individuals were one of the most vulnerable to experiencing severe medical issues due to the SARS-CoV-2 infection. Although transmitting the SARS-CoV-2 infection during gestation is reportedly uncommon, there is still a possibility that systemic inflammatory response can have an impact.

As a result, a cohort study published JAMA Network Open¹ sought to take it a step further by investigating whether or not there is indeed a connection between prenatal exposure to the SARS-CoV-2 infection and child neurodevelopment throughout the first two years of life.

The participating children were selected from the pan-Canadian longitudinal Pregnancy During the COVID-19 Pandemic Study,^2.3 a longitudinal, population-based pregnancy cohort that was intended to study the effect of the COVID pandemic on pregnant individuals and their children throughout Canada; participants were recruited from April 2020 to July 2022. Per eligibility requirements, pregnant individuals needed to reside in Canada, be 17 years of age or older, be able to read and write in English or French, and be no more than 35 weeks’ gestation at the time of enrollment.

In order for the children to be considered exposed to the prenatal SARS-CoV-2 infection, the birthing parent had to have had a positive polymerase chain reaction test performed by a health authority. In order to be considered negative and a part of the comparison group, the birthing parent should not have had SARS-CoV-2 antibodies in their postpartum dried blood spot sample.

Out of the 896 children that were included in the study, 96 children had been exposed to a prenatal SARS-CoV-2 infection (mean [SD] gestational age at birth, 39.20 [1.50] weeks; 45 [47%] male) and 800 were healthy negative comparisons (mean [SD] gestational age at birth, 39.47 [1.54] weeks; 388 [49%] male).

In analyses of covariance adjusted for pre-pregnancy medical conditions and household socioeconomic status, prenatal exposure to SARS CoV-2 infection was connected to a slightly higher regulatory control scores, which meant more regulation at the age of 6 months (difference in means, 0.19 [95% confidence interval, CI, 0.02-0.36]; P = .03; ηp2 = 0.01). There were no meaningful differences that were observed for the other neurodevelopmental outcomes.

The study investigators concluded that overall, “… prenatal SARS-CoV-2 exposure had a negligible association with child neurodevelopment between 6 and 24 months of age. Follow-up research is warranted to evaluate whether these predominantly null effects persist into later childhood.”

References

1. Vrantsidis DM, van de Wouw M, Hall ERM, et al. Neurodevelopment in the First 2 Years of Life Following Prenatal Exposure to Maternal SARS-CoV-2 Infection. JAMA Netw Open. 2024;7(11):e2443697. doi:10.1001/jamanetworkopen.2024.43697

2. Giesbrecht GF, Bagshawe M, van Sloten M, et al. Protocol for the Pregnancy During the COVID-19 Pandemic (PdP) study: a longitudinal cohort study of mental health among pregnant Canadians during the COVID-19 pandemic and developmental outcomes in their children. JMIR Res Protoc. 2021;10(4):e25407. doi:10.2196/25407

3. Lebel C, Tomfohr-Madsen L, Giesbrecht G, et al. Prenatal mental health data and birth outcomes in the pregnancy during the COVID-19 pandemic dataset. Data Brief. 2023;49:109366. doi:10.1016/j.dib.2023.10936