232 - Maternal SARS-CoV-2 Infection during pregnancy and later infant neurodevelopment

Emerging research suggests that while vertical transmission of coronavirus SARS-CoV-2 is rare, the long-term impact of maternal Covid-19 infection in utero may influence the infant’s the developing brain, nervous, and immune systems.

Objective:

To evaluate maternal COVID-19 infection illness effects on infant motor, cognitive, and sensory development up to 24 months of age.

Design/Methods:

A retrospective analysis of a prospectively collected single cohort of mothers and their infants, with clinically diagnosed with COVID-19 infection during gestation, admitted to VCU Health System between 2019-2021. Demographics, comorbidities, illnesses, and infant neurodevelopmental outcomes based on the Survey of Well Being of Young Children (SWYC) at 12-24 months after birth were collected from medical records and analyzed using descriptive statistics, chi-square tests, t-tests, and ANOVA tests.

Results:

In this analysis 112 mothers and 116 infants qualified for inclusion. Of the 112 mothers, 57% (N=64) were asymptomatic, 36% (N=40) had mild-moderate symptoms, and 7% (N=8) had severe illness during gestation. There were 66% (N=70) Hispanic mothers, followed by 21% (N=24) African American, 15% (N=17) Caucasian, and 4% (N=6) other. There was developmental delay in 32% of infants at 12 months and 38% with neurocognitive delay at 24 months. At 12 months of age the most prevalent neurocognitive delays were gross motor (44.6%) and fine motor (20%) while the most prevalent neurocognitive delay at 24 months were speech/language (50%) and gross motor (23.1%). Neurocognitive delay varied by maternal race with 28/70 (44%) of Hispanic mothers having a child with neurodevelopmental delay, 0% of children born to African American mothers, and 2/17 (12%) born to Caucasian mothers. Maternal pre-existing conditions did not influence infant’s risk for neurodevelopmental delay.  There was no association of maternal immune disease, allergies or other illnesses on neurodevelopmental delay risk.

Conclusion(s):

Maternal COVID19 infection was associated with a 2-fold increase in the incidence of later infant neurodevelopmental delay at 12 and 24 months. Severity of maternal illness did not appear to play a significant role in the associated neurocognitive delay. Infants born to mothers of Hispanic background demonstrated an increased incidence of neurocognitive delay suggesting further racial ethnic morbidity risk in this population.