Growth and Neurodevelopmental Outcomes of Infants Born to Women with Covid-19 During Pregnancy

Objective: To rigorously assess infant growth and neurodevelopment during the first six months of life, we assessed outcomes in a prospective cohort of infants exposed to COVID-19 in utero and compared those outcomes to matched controls.Methods: A prospective cohort of pregnant women with documented COVID-19 during pregnancy were recruited. Infant growth parameters were collected at delivery, two and six months postpartum. Parent and clinician standardized development assessments (Ages and Stages Questionnaire and Bayley) were completed at two and six months. Paired and unpaired t-tests were used to compare infant neurodevelopment over time and to pre-pandemic and pandemic matched controls, respectively.Results: From 26 pregnant women recruited, 25 (96%) deliveries, 18 (69%) 2-month, and 16 (61%) 6-month visits were completed. SARS-CoV-2 infections occurred in 1st trimester (8%), 2nd trimester (23%), 3rd trimester (46%), and at delivery (23%). Growth trajectories and developmental scores compared to the standards were normal for exposed infants except for one child who demonstrated developmental delay in more than one domain at 6 months. When compared to controls, exposed children scored lower in the Bayley-IV cognitive domain (102.7; standard deviation (SD):14.7) compared to pre-pandemic (117.8; SD:14.6; p=0.002) and pandemic (116.6; SD:12.6; p=0.008) geographically matched controls but not external pre-pandemic controls (109.7; SD:11.9; p=0.09). There were no other differences in other domains.Conclusions: Infants exposed to COVID-19 during pregnancy may be at risk for mild adverse neurodevelopmental outcomes and should be routinely screened using standardized tools at well-child visits.