Intrauterine SARS-CoV-2 Exposure and Infant Neurodevelopment through 18 Months of Age: Findings from the Researching COVID to Enhance Recovery (RECOVER) Pregnancy Study.
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Flaherman Valerie J, Reeder Harrison T, Martin-Herz Susanne P, Gallagher Richard, Cohen Alison K, Brown Heather-Elizabeth, Clifton Rebecca G, Fischbein Nicole, Foulkes Andrea S, Jacoby Vanessa L, Jain Nita, Beamon Carmen J, Bahtiyar Mert Ozan, Chang Ann, Costantine Maged M, Cruz Irving Angelique, Gibson Kelly S, Hoffman M Camille, Hoffman Matthew K, Hughes Brenna L, Katz Stuart D, Laleau Victoria, Mendez-Figueroa Hector, Monteiro Jonathan, Okumura Megumi J, Pacheco Luis D, Palomares Kristy T S, Parry Samuel, Plunkett Beth A, Reddy Uma M, Rouse Dwight J, Saade George R, Sandoval Grecio J, Simhan Hyagriv N, Skupski Daniel W, Sowles Amber, Thorp John M, Tita Alan T N, Weiner Steven J, Wiegand Samantha, Yee Lynn M, Gross Rachel S, Metz Torri D, RECOVER-Pregnancy Consortium
Аннотация
STUDY DESIGN: The Researching COVID to Enhance Recovery (RECOVER) Pregnancy Cohort enrolled adults with and without SARS-CoV-2 during pregnancy and their offspring born January 2020 through December 2023 at 23 sites across the US. Neurodevelopment was assessed at 12 months with the Ages & Stages Questionnaire, 3rd edition (ASQ-3) and at 18 months with the ASQ Social-Emotional (ASQ-SE) and the Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R). We compared exposed and unexposed infants' ASQ-3 total and subdomain scores, ASQ-SE and M-CHAT-R scores, and proportions meeting published referral thresholds, using multivariable linear and logistic regression.
RESULTS: Among 1179 participants enrolled, 1008 (85.5%) had exposure, with 806 (80.0%) exposed during Omicron predominance. Of those with known timing, 349 (41.4%) and 295 (35.0%) were exposed in the second and third trimesters of pregnancy, respectively. Exposure was not associated with differences in the ASQ-3 (adjusted difference -0.61, 95% CI -10.03 to 8.81) or ASQ-3 subdomains at 12 months, ASQ-SE at 18 months (adjusted difference 0.19, 95% CI -4.02 to 4.41), or M-CHAT-R scores. Findings were similar for proportions meeting referral thresholds and when stratified by variant or by trimester.
CONCLUSIONS: In this multicenter cohort largely exposed since Omicron and in second or third trimester, intrauterine SARS-CoV-2 exposure was not associated with neurodevelopmental screening outcomes through 18 months of age. Further assessments of the impact of intrauterine SARS-CoV-2 on neurodevelopment beyond 18 months of age are needed.