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A new study based on a cohort of Brazilian infants shows those who were exposed to SARS-CoV-2 infections in the uterus may be at an increased risk for developmental delays in the first year of life. The study appeared yesterday in the International Journal of Infectious Diseases.
Women in northern Brazil were assessed from April 2020 to July 2021. Researchers compared outcomes among a case group of 69 children who were exposed to lab-confirmed COVID-19 in utero compared to 68 children who served as controls, and had no known exposure to COVID-19 in utero.
"All mothers were unvaccinated at the time of cohort inclusion, and maternal demographics were similar in the two groups," the authors wrote.
At 12 months, 20.3% of COVID-exposed children and 5.9% of the controls received a diagnosis of neurodevelopmental delay (risk ratio, 3.44; 95% confidence interval, 1.19 to 9.95).
For the exposed group, the prevalence of neurodevelopment impairment using the Ages & Stages Questionnaire (ASQ-3) was 35.7% at 4 months, 7.0% at 6 months, and 32.1% at 12 months.
Delays seen at 4, 12 months
"Over 50% of the SARS-CoV-2 exposed infants presented ASQ-3 scores below the expected cutoff, with about half classified with neurodevelopmental delay, mainly at 4 and 12 months,” the authors wrote.
Over 50% of the SARS-CoV-2 exposed infants presented ASQ-3 scores below the expected cutoff.
Previous studies conducted in the United States and elsewhere have shown a risk of delays in infants exposed to COVID-19 infections in utero, but this is the first study to look at the phenomenon in northern Brazil.
In follow-up of exposed infants, the researchers found 10% had an abnormal result on cranial ultrasonography, mainly mild ventriculomegaly, a swelling in the brain caused by cerebrospinal fluid buildup.
"That has been described with other congenital infections, like cytomegalovirus and Zika virus," they wrote. "Although the findings were mostly mild, there was an association between the diagnosis of abnormalities and the risk of developmental delay."