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Poster #118 - Is gestational SARS-CoV-2 exposure associated with child developmental delays at six months?

Fri, March 24, 8:30 to 9:15am, Salt Palace Convention Center, Floor: 1, Hall A-B

Abstract

Introduction: Much has been studied about the effects of gestational SARS-CoV-2 infection on newborns and their mothers. Nevertheless, mid and long-term outcomes, such as developmental and behavioral problems, are still under investigation. Objective: to analyze the association between gestational exposure to SARS-CoV-2 and child development at six months. Methods: It is a prospective cohort study comparing the global development of infants exposed (n=278) and non-exposed (n=270) to SARS-CoV-2 during gestation. The sample was recruited during neonatal screening (first week post-partum) between April and August/2021 in five Brazilian municipalities. Mothers who accepted to participate in the study collected serology for IgG against SARS-CoV-2 at the same time as their neonates, using dried blood spots (DBS) collected for standard neonatal screening. When infants were six months old, mothers answered a phone call interview regarding the socioeconomic, demographic, and perinatal conditions and child health and development. The screen for developmental delays was performed using the Brazilian version of the Survey of Well-being of Young Children (SWYC-BR), which assess language, cognitive, and motor domains based on parents’ report. We used Brazilian norms to classify infants as “development expected to age” or “ suspected of developmental delay”. Infants were considered exposed to SARS-CoV-2 if they or their mothers were seropositive for coronavirus-2 in the first week post-partum or if their mothers had a SARS-CoV-2 positive RT-PCR during pregnancy. Exposed and non-exposed children were compared using Chi-square Test (significance level 5%). The study was approved by the Universidade Federal de Minas Gerais Ethical Committee and corresponds to the first assessment of a two-year follow-up. Results: Most infants were born at term (96%) and weighing more than 2,500g (97%). Cesarian was the via of partum for 48% of the neonates. Exclusive breastfeeding was present in 35% of the sample at six months. Most infants had regular well-being consultations during the six months after (91%) and did not attend daycare centers (97%). Mothers studied for 9 to 11 years (63%), and the families’ socioeconomic status was low (62%), according to Brazilian Criteria. There were no statistical differences between exposed and non-exposed groups regarding the abovementioned variables (Table 1). The moment of the SARS-CoV-2 maternal infection was unknown in 47.5% of the cases. Among mothers with a detectable RT-PCR (n=146), 12% were in the first, 38% in the second, and 50% in the third trimester. Most mothers had mild or moderate COVID-19 symptoms during pregnancy. In the first week post-partum, 34% of mothers and 39% of neonates were IgG seropositive; nobody had COVID-19 symptoms at the moment of the test (Figure 1). The prevalence of suspected developmental delay was 22.7% in exposed infants and 21.9% in the non-exposed group (p=0.90). Conclusions: The general prevalence of suspected developmental delay was higher than described before the pandemic in other studies using screening tools in Brazil. We did not observe an association between exposure to SARS-CoV-2 during pregnancy and suspected developmental delay at six months. However, the absence of early developmental delays does not reassure the long-term outcomes secondary to gestational SARS-CoV-2 exposure.

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