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NEUROMOTOR REPERTOIRES IN INFANTS EXPOSED TO MATERNAL COVID-19 DURING PREGNANCY: A COHORT STUDY
Martinez, Viviana Fajardo et al. | Date Issued: 2023
Author
Martinez, Viviana Fajardo
Zhang, Dajie
Paiola, Sophia
Mok, Thalia
Cambou, Mary C.
Kerin, Tara
Rao, Rashmi
Brasil, Patricia
Ferreira, Fatima
Fuller, Trevon
Bhattacharya, Debika
Foo, Suan-Sin
Chen, Weiqiang
Jung, Jae
Einspieler, Christa
Marschik, Peter B.
Nielsen-Saines, Karin
Affilliation
University of California Los Angeles. Pediatrics, David Geffen School of Medicine. Los Angeles, CA, USA.
University Medical Center Göttingen and Leibniz-ScienceCampus Primate Cognition. Child and Adolescent Psychiatry and Psychotherapy. Göttingen, Germany / iDN - interdisciplinary Developmental Neuroscience. Division of Phoniatrics. Medical University of Graz. Graz, Austria.
University of California Los Angeles. Pediatrics, David Geffen School of Medicine. Los Angeles, CA, USA.
University of California Los Angeles. David Geffen School of Medicine. Obstetrics and Gynecology. Los Angeles, CA, USA.
University of California Los Angeles. David Geffen School of Medicine. Internal Medicine. Los Angeles, CA, USA.
University of California Los Angeles. Pediatrics, David Geffen School of Medicine. Los Angeles, CA, USA.
University of California Los Angeles. David Geffen School of Medicine. Obstetrics and Gynecology. Los Angeles, CA, USA.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Acute Febrile Illnesses. Rio de Janeiro, RJ, Brazil.
Universidade do Rio de Janeiro. Escola de Medicina. Pediatrics. Rio de Janeiro, RJ, Brazil.
University of California. David Geffen School of Medicine. Department of Pediatrics. Los Angeles, California, USA / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Doenças Febris Agudas. Rio de Janeiro, RJ, Brasil.
University of California Los Angeles. David Geffen School of Medicine. Internal Medicine. Los Angeles, CA, USA.
Cancer Biology, Lerner Research Institute. Cleveland Clinic. Cleveland, Ohio, USA.
Cancer Biology, Lerner Research Institute. Cleveland Clinic. Cleveland, Ohio, USA.
Cancer Biology, Lerner Research Institute. Cleveland Clinic. Cleveland, Ohio, USA.
iDN - interdisciplinary Developmental Neuroscience. Division of Phoniatrics. Medical University of Graz. Graz, Austria.
University Medical Center Göttingen and Leibniz-ScienceCampus Primate Cognition. Child and Adolescent Psychiatry and Psychotherapy. Göttingen, Germany / iDN - interdisciplinary Developmental Neuroscience. Division of Phoniatrics. Medical University of Graz. Graz, Austria / Center of Neurodevelopmental Disorders. Centre for Psychiatry Research; Department of Women's and Children's Health. Karolinska Institutet. Stockholm, Sweden.
University of California. David Geffen School of Medicine. Department of Pediatrics. Los Angeles, California, USA.
Abstract
Objective: To evaluate neuromotor repertoires and developmental milestones in infants exposed to antenatal COVID-19. Design: Longitudinal cohort study. Setting: Hospital-based study in Los Angeles, USA and Rio de Janeiro, Brazil between March 2020 and December 2021. Participants: Infants born to mothers with COVID-19 during pregnancy and prepandemic control infants from the Graz University Database. Interventions: General 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 measures: Motor Optimality Scores Revised (MOS-R) at 3-5 months. Presence of developmental delay (DD) at 6-8 months. Results: 239 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). Conclusions: Compared with prepandemic controls, infants exposed to antenatal COVID-19 more frequently had suboptimal neuromotor development.
Keywords
COVID-19
Maternal medicine
Paediatric infectious disease & immunisation
Paediatric neurology
 
Publisher
BMJ Publishing Group Ltd.
Citation
MARTINEZ, Viviana Fajardo et al. Neuromotor repertoires in infants exposed to maternal COVID-19 during pregnancy: a cohort study. BMJ Open, v. 13, n. 1, p. 1-9, Jan. 2023.
DOI
10.1136/bmjopen-2022-069194
ISSN
2044-6055
Notes
Ethics approval The study was approved by Institutional review boards at UCLA (IRB protocol 20-000569) and Fundação Oswaldo Cruz (Fiocruz/National Ethics Committee CONEP 30639420.0.0000.5262) with informed consent obtained from parents.