Infants born during pandemic scored lower on developmental test at 6 months

Infants born during the last 9 months of 2020 scored lower on gross motor, fine motor and personal-social subdomains compared with a cohort of infants born before the COVID-19 pandemic, according to study published in JAMA Pediatrics.

Originally, Dani Dumitriu, MD, PhD, a pediatrician at Columbia University Irving Medical Center, and colleagues were studying differences between mothers who tested positive for COVID-19.

“We initially looked, primarily, at differences between moms who did and did not have COVID during pregnancy. In terms of that we had really good news: there was no difference,” Dumitriu told Healio.

“So, maternal infection during pregnancy does not look like it affects child development,” Dumitriu said. “But then we also happened to have had a control cohort, born at our hospital. The same group had also filled in an online edition of the Ages and Stages Questionnaire (ASQ). We were able to compare these very similar populations to each other, and to tell if there were differences in those babies that were born during the pandemic vs. those who were born in the 3 years prior. And that's where we found the effect.”

As part of the study, 255 mothers whose children were born between March and December 2020 filled out the ASQ, which is widely used in pediatrics as a screening tool for potential problems. The results were not a cause for alarm, Dumitriu said.

“In our sample we did not see an overall increased risk of actual failures on the ASQ,” Dumitriu said. “Clinically speaking, this is a very small effect — it was just a basically a slight shift in the average score of the baby.”

Both prenatal and postnatal factors could play roles in the neurodevelopment, she said .

“Maternal stress in both humans and animal models have been shown to affect the development of the fetus, and then later on, the development of the child,” Dumitriu said.

Other noteworthy factors include access to health care.

“For the women that were early in pregnancy [when] the pandemic hit, which is where we saw the biggest effects, you know, perhaps they didn’t go the doctor regularly or other doctor appointments were canceled,” Dumitriu said. “We had a lot of shutdowns and a lot of places really only saw patients for emergencies rather than for helping preventive causes. Then, of course, there's likely to also be contributing factors postnatally, even though in our data set, it looks like this really, truly was a prenatal effect. But there's likely to be contributing factors postnatally, in terms of the changes we're seeing in society, in terms of people going out less [and] people likely taking babies out less. The use of masks is probably contributing.”

Dumitriu said the researchers were still speculating at this stage.

“At this stage, we’re just speculating about potential causes for what we're seeing, most likely it’s not going to be, you know, one thing contributing, but definitely multiple factors,” Dumitriu said. “That's definitely part of what we're interested in doing in our future work in order to try to understand it. The most important thing here is that we don't know the main answer.”

She added that the future might be more optimistic, so long as more research and more vigilant examination take hold.

“The ASQ is a great tool to look at the present, but not to look at the future,” Dumitriu said. “And babies at 6 months of age are very, very malleable. Their brains can just absorb new information and change very rapidly.

“The most important take-home point is that when these babies are 2 years old, we might find that this effect has gone away, that they caught up or perhaps gone even above average. And so, there's nothing that that is written in stone, but if this is foreshadowing a potential problem for these babies, then we also have a lot of work to intervene. But because baby's brains are so plastic, there's lots of things that we can do in the meantime.”