The Association between Antenatal SARS-CoV-2 Exposure and Infant Neurodevelopment at Four Months of Age: A Prospective Multicenter Cohort Survey within the COPE StudyDepartment of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
Department of Pediatrics, Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Department of Pediatrics, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Women´s and Children´s Health, Karolinska Institutet, Stockholm, Sweden; Neonatal unit, Karolinska University Hospital, Stockholm, Sweden.
Department of Biomedical and Clinical Sciences, Linköping University and Crown Princess Victoria Children´s Hospital, Linköping, Sweden.
Department of Obstetrics and Gynaecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, NU Hospital Group, Department of Obstetrics and Gynaecology, Trollhättan, Sweden.
Linköping University, Department of Biomedical and Clinical Sciences, Linköping, Sweden; Department of Obstetrics and Gynecology, Vrinnevihospital, Norrköping, Sweden.
Centre for Pharmacoepidemiology, Department of Medicine, Karolinska Institute Solna, Stockholm, Sweden.
Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
Department of Clinical Sciences Lund, Obstetrics and Gynaecology, Lund University and Skåne University Hospital, Lund, Sweden.
Department of Obstetrics and Gynaecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Obstetrics and Gynaecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Obstetrics and Gynaecology, Gothenburg, Sweden.
Institute of Biomedicine, Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg; Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Obstetrics and Gynaecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Obstetrics and Gynaecology, Gothenburg, Sweden.
Department of Obstetrics and Gynaecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Obstetrics and Gynaecology, Gothenburg, Sweden.
Department of Neonatology, Skåne University Hospital, Malmö/Lund, Sweden; Department of Clinical Sciences Lund, Pediatrics, Lund University, Lund, Sweden.
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2025 (English)In: International Journal of Infectious Diseases, ISSN 1201-9712, E-ISSN 1878-3511, Vol. 158, article id 107973
Article in journal (Refereed) Published
Abstract [en]
OBJECTIVES: It remains unclear whether antenatal SARS-CoV-2 exposure affects subsequent infant neurodevelopment. We aimed to investigate the association between antenatal maternal SARS-CoV-2 infection and neurodevelopment in four-month-old infants.
METHODS: Data was collected within the prospective multicenter COVID-19 during pregnancy and early childhood study, COPE (NCT04433364). Infants exposed to maternal SARS-CoV-2 infection from conception until two days postpartum and unexposed controls were included June 2020-December 2022.
PRIMARY OUTCOME: four-month-old infant neurodevelopment, measured using the Ages and Stages Questionnaire 3rd Edition (ASQ) total mean scores.
SECONDARY OUTCOMES: Scores below cutoff for total ASQ or the ASQ domains. RESULTS: Of 2,453 enrolled infants, 1,446 (555 exposed and 891 unexposed) had available ASQ data. In adjusted regression models, there was no group difference in ASQ total mean scores. Exposed infants had lower risk of fine motor domain scores below cutoff (exposed: 4.0% vs. unexposed: 6.6%; adjusted odds ratio (aOR), 0.55; 95% CI, 0.33-0.92). Infants exposed to severe maternal COVID-19 had increased risk of total ASQ scores below cutoff (exposed: 16.0% vs. unexposed: 6.1%; aOR, 3.57; 95% CI, 1.14-11.24).
CONCLUSIONS: Antenatal maternal SARS-CoV-2 infection was not associated with overall impaired four-month infant neurodevelopmental screening. In exploratory analyses, severe maternal COVID-19 was associated with abnormal screening results.
Place, publisher, year, edition, pages
Elsevier, 2025. Vol. 158, article id 107973
Keywords [en]
Child Development, Infant, Infectious, Neurodevelopmental Disorders, Pregnancy Complications, Prenatal Exposure Delayed Effects, SARS-CoV-2
National Category
Pediatrics
Identifiers
URN: urn:nbn:se:oru:diva-122364DOI: 10.1016/j.ijid.2025.107973ISI: 001543159800002PubMedID: 40617344Scopus ID: 2-s2.0-105011686784OAI: oai:DiVA.org:oru-122364DiVA, id: diva2:1982356
Funder
Region Västra Götaland, VGFOUREG-938771
Note
Funding Agencies:
The study was financed by grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF agreement (KL ALFGBG-1006131, YC ALFGBG-75710, YC ALFGBG-77860, VS ALFGBG-970689, MZ, 2020-YF0016, MZ YF00054, JB ST43739, OA 2020-Projekt0117) and regional research funding Western health care region (VS, VGFOUREG-938771).
2025-07-082025-07-082026-01-23Bibliographically approved