Importance Associations between in utero exposure to maternal SARS-CoV-2 infection and neurodevelopment are speculated, but currently unknown. Objective To examine the associations between maternal SARS-CoV-2 infection during pregnancy, being born during the COVID-19 pandemic regardless of maternal SARS-CoV-2 status, and neurodevelopment at age 6 months. Design, Setting, and Participants A cohort of infants exposed to maternal SARS-CoV-2 infection during pregnancy and unexposed controls was enrolled in the COVID-19 Mother Baby Outcomes Initiative at Columbia University Irving Medical Center in New York City. All women who delivered at Columbia University Irving Medical Center with a SARS-CoV-2 infection during pregnancy were approached. Women with unexposed infants were approached based on similar gestational age at birth, date of birth, sex, and mode of delivery. Neurodevelopment was assessed using the Ages & Stages Questionnaire, 3rd Edition (ASQ-3) at age 6 months. A historical cohort of infants born before the pandemic who had completed the 6-month ASQ-3 were included in secondary analyses. Exposures Maternal SARS-CoV-2 infection during pregnancy and birth during the COVID-19 pandemic. Main Outcomes and Measures Outcomes were scores on the 5 ASQ-3 subdomains, with the hypothesis that maternal SARS-CoV-2 infection during pregnancy would be associated with decrements in social and motor development at age 6 months. Results Of 1706 women approached, 596 enrolled; 385 women were invited to a 6-month assessment, of whom 272 (70.6%) completed the ASQ-3. Data were available for 255 infants enrolled in the COVID-19 Mother Baby Outcomes Initiative (114 in utero exposed, 141 unexposed to SARS-CoV-2; median maternal age at delivery, 32.0 [IQR, 19.0-45.0] years). Data were also available from a historical cohort of 62 infants born before the pandemic. In utero exposure to maternal SARS-CoV-2 infection was not associated with significant differences on any ASQ-3 subdomain, regardless of infection timing or severity. However, compared with the historical cohort, infants born during the pandemic had significantly lower scores on gross motor (mean difference, -5.63; 95% CI, -8.75 to -2.51; F1,267 = 12.63; P<.005), fine motor (mean difference, -6.61; 95% CI, -10.00 to -3.21; F1,267 = 14.71; P < .005), and personal-social (mean difference, -3.71; 95% CI, -6.61 to -0.82; F1,267 = 6.37; P<.05) subdomains in fully adjusted models. Conclusions and Relevance In this study, birth during the pandemic, but not in utero exposure to maternal SARS-CoV-2 infection, was associated with differences in neurodevelopment at age 6 months. These early findings support the need for long-term monitoring of children born during the COVID-19 pandemic.

中文翻译：

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COVID-19 大流行期间出生与 6 个月时有和没有在子宫内暴露于母体 SARS-CoV-2 感染的婴儿的神经发育状态的关联。

推测在子宫内暴露于母体 SARS-CoV-2 感染与神经发育之间存在重要关联，但目前尚不清楚。目的 研究母体在怀孕期间感染 SARS-CoV-2、在 COVID-19 大流行期间出生（无论母体 SARS-CoV-2 状态如何）与 6 个月时的神经发育之间的关联。设计、设置和参与者 纽约市哥伦比亚大学欧文医学中心的 COVID-19 母婴结果计划招募了一组在怀孕期间暴露于母体 SARS-CoV-2 感染的婴儿和未暴露的对照组。接触了所有在哥伦比亚大学欧文医学中心分娩并在怀孕期间感染 SARS-CoV-2 的妇女。根据相似的出生胎龄、出生日期、性别、和交货方式。在 6 个月大时使用年龄和阶段问卷第 3 版 (ASQ-3) 评估神经发育。完成 6 个月 ASQ-3 的大流行之前出生的一组历史婴儿被纳入二次分析。在 COVID-19 大流行期间怀孕和分娩期间接触母体 SARS-CoV-2 感染。主要结果和测量结果是 5 个 ASQ-3 子域的分数，假设母亲在怀孕期间感染 SARS-CoV-2 与 6 个月大时社交和运动发育的下降有关。结果 接触了 1706 名女性，其中 596 名被录取；385 名女性受邀参加为期 6 个月的评估，其中 272 名 (70.6%) 完成了 ASQ-3。可获得 255 名参加 COVID-19 母婴成果倡议的婴儿的数据（114 名在子宫内暴露，141 人未接触过 SARS-CoV-2；产妇分娩年龄中位数，32.0 [IQR，19.0-45.0] 岁）。数据也可从大流行前出生的 62 名婴儿的历史队列中获得。在子宫内暴露于母体 SARS-CoV-2 感染与任何 ASQ-3 子域的显着差异无关，无论感染时间或严重程度如何。然而，与历史队列相比，大流行期间出生的婴儿粗大运动得分明显较低（平均差，-5.63；95% CI，-8.75 至 -2.51；F1,267 = 12.63；P<.005），很好运动（平均差，-6.61；95% CI，-10.00 至 -3.21；F1,267 = 14.71；P < .005）和个人-社会（平均差，-3.71；95% CI，-6.61 至 -0.82 ; F1,267 = 6.37; P<.05) 完全调整模型中的子域。结论和相关性 在这项研究中，大流行期间的出生，但不是在子宫内暴露于母体 SARS-CoV-2 感染，与 6 个月大时神经发育的差异相关。这些早期发现支持对 COVID-19 大流行期间出生的儿童进行长期监测的必要性。