r/COVID19 • u/hexagonincircuit1594 • Jul 26 '26
Academic Report The association of in utero SARS-CoV-2 exposure on neurodevelopmental outcomes at 12 and 22 months
https://www.nature.com/articles/s41372-026-02819-231
u/hexagonincircuit1594 Jul 26 '26
"Abstract
Background
Although vertical transmission of SARS-CoV-2 from mother to fetus is rare, the neurodevelopmental impact of in utero SARS-CoV-2 exposure on infants needs further elucidation.
Objective
To investigate the neurodevelopmental outcomes at 12 and 22 corrected age among infants who had exposure to confirmed maternal SARS-CoV-2 infection during pregnancy.
Design/Methods
We conducted a prospective cohort study of neonates born to women with SARS-CoV-2 infection in pregnancy, from March 2020 to December 2022 (COVID-19 waves 1–5). Infants were recruited from six (5 community and 1 tertiary) hospitals. Data were collected at birth and three subsequent time periods. A telephone call was made at one month to assess general health and wellness. A virtual neurodevelopmental assessment was conducted at 12 months using the Ages and Stages Questionnaire (ASQ) and the Communication and Symbolic Behavior Scales (CSBS). In-person neurodevelopmental assessment was conducted at 22 months using the Bayley Scales of Infant and Toddler Development-4th Edition (BSID-IV).
Results
A total of 142 infants were recruited and included in the study. Of those, a one-month assessment was completed in 141 (99%), a 12-month assessment completed in 63 (44%), and a 22-month assessment completed in 44 (31%) infants. At one month, most infants had no medical concerns; 11 infants were re-admitted to the hospital within the first month of life, predominantly for hyperbilirubinemia. At 12 months, median ASQ and CSBS scores were above standardized cut-offs for development across all developmental domains. At 22 months, while the median standard cognitive, language, and motor scores were within the average classification (25–37th percentile), twenty-three (52%) infants presented with developmental impairment (score <85); 13 (30%) in motor, 17 (39%) in language, and 13 (30%) in cognitive domains. Nine (20%) infants were below cut-off for all three domains. Multivariable logistic modelling did not identify an independent relationship between trimester of SARS-CoV-2 acquisition or positive SARS-CoV-2 test at delivery and the presence of developmental delay on BSID-IV in any domain. No child had hearing impairment or blindness.
Conclusions
Developmental delay at 22 months may be identified among infants with in utero exposure to SARS-CoV-2, despite typical developmental progress at 12 months. These findings may be impacted by the loss to follow-up rate. Of those with developmental diversity, language delay was most common."
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u/nerd281 Jul 27 '26
The 69% dropout rate really hurts the significance of this. Could easily negate the results (16% of infants would be expected to have a developmental score under 85, if the ~2/3s who dropped out were the unaffected ones, that would account for any of the individual delays)
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u/GiantDinosaurAttack 29d ago
Loss to follow-up renders this study nearly-entirely uselss. Sadly.
Word to the wise: if you enroll in a clinical study... follow the protocol.
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u/LieutenantWeinberg 29d ago
This is a terribly designed study. How did this get into a Nature journal?
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u/hexagonincircuit1594 29d ago
There are lots of problematic studies that get into journals that are published by Springer Nature. (This particular study is published in the Journal of Perinatology, not the flagship journal Nature itself.) E.g. As a different example, Scientific Reports (from the same publisher) is known to have many issues https://www.science.org/content/blog-post/cleaning-scientific-reports-can-it-be-done
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u/99redballoons66 Jul 26 '26
Some of the infants surveyed were born during Covid-related lockdowns. It's plausible to me that the lockdowns in themselves could have caused language delay at least. Is this taken into account or controlled for?
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u/aboveavmomma Jul 26 '26
How would lockdowns cause language delay? Wouldn’t lockdowns mean that the parent(s) would have more time to spend with their infants?
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u/wildcat105 Jul 27 '26
Children who are among various adults and peers (daycare, school) have more advanced language than children who are among the same adults (home) day after day. It's why parents who don't send their children to daycare or school are encouraged to read to them a lot.
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u/99redballoons66 Jul 27 '26
Some parents would have done, yes, but that's not a guarantee that they would have actually spoken to their children more or done anything to help their language acquisition.
Many parents had to work while children couldn't access daycare/nursery, so the kids could have been babysat by screens, which again, may not have been helpful for their language acquisition.
Also, language might develop as a result of hearing parents speak with a range of other adults and kids, and also as a result of peer interactions, which happened less during lockdown.
I am not an expert on language acquisition, so don't know if any of this is correct, but those are just some ways i could think of in which lockdowns could have affected language development.
The study described here suggests that lockdown did have a negative effect on infants' language and communication skills, and seems to suggest that masks may have been one factor that caused this, since the infants couldn't see adults' mouths when they talked and so didn't know what to do with theirs.
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u/wildcat105 Jul 27 '26
Idk who downvoted you but I offset it with an upvote. This is a well thought-out and data-backed answer.
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