Abstract：
BACKGROUND: The effects of SARS-CoV-2 gestational exposure on child development remain inconclusive.
OBJECTIVE: To analyze the effects of SARS-CoV-2 gestational exposure on neurodevelopment until 12 months.
METHODS: Prospective cohort study conducted in five municipalities in Southeast Brazil from August 2021 to September 2022.
METHODS: Infants were recruited from a serological survey performed during neonatal screening and followed up to 12 months old. We included 224 infants exposed to SARS-CoV-2 during pregnancy and 225 non-exposed, according to the serology results of the newborn as well as their mothers and the maternal antenatal RT-PCR results.
METHODS: Developmental assessments were performed at 6 and 12 months using the Survey of Wellbeing of Young Children-Brazilian Version (SWYC-BR). Children with suspected developmental delay (SDD) at 6 and 12 months were considered at high risk for developmental delay (HRDD). Additionally, risk factors associated with SDD were examined.
RESULTS: There were 111 children identified with SDD and 52 with HRDD. SARS-CoV-2 gestational exposure was not associated with SDD. Exposure in the first gestational trimester increased SDD risk by 2.15 times compared to the third. Cesarean delivery predicted SDD (OR 1.56; 95%CI 1.01-2.42) and HRDD (OR 1.91; 95%CI 1.04-3.48). Additionally, suspected maternal depression predicted SDD (OR 1.76; 95%CI 1.01-3.10).
CONCLUSIONS: SARS-CoV-2 gestational exposure did not increase the developmental delay risk. However, our findings suggest that the earlier the gestational exposure, the greater the developmental delay risk at 12 months. Cesarean delivery and suspected maternal depression increased the developmental delay risk, independent of virus exposure.
OBJECTIVE: To analyze the effects of SARS-CoV-2 gestational exposure on neurodevelopment until 12 months.
METHODS: Prospective cohort study conducted in five municipalities in Southeast Brazil from August 2021 to September 2022.
METHODS: Infants were recruited from a serological survey performed during neonatal screening and followed up to 12 months old. We included 224 infants exposed to SARS-CoV-2 during pregnancy and 225 non-exposed, according to the serology results of the newborn as well as their mothers and the maternal antenatal RT-PCR results.
METHODS: Developmental assessments were performed at 6 and 12 months using the Survey of Wellbeing of Young Children-Brazilian Version (SWYC-BR). Children with suspected developmental delay (SDD) at 6 and 12 months were considered at high risk for developmental delay (HRDD). Additionally, risk factors associated with SDD were examined.
RESULTS: There were 111 children identified with SDD and 52 with HRDD. SARS-CoV-2 gestational exposure was not associated with SDD. Exposure in the first gestational trimester increased SDD risk by 2.15 times compared to the third. Cesarean delivery predicted SDD (OR 1.56; 95%CI 1.01-2.42) and HRDD (OR 1.91; 95%CI 1.04-3.48). Additionally, suspected maternal depression predicted SDD (OR 1.76; 95%CI 1.01-3.10).
CONCLUSIONS: SARS-CoV-2 gestational exposure did not increase the developmental delay risk. However, our findings suggest that the earlier the gestational exposure, the greater the developmental delay risk at 12 months. Cesarean delivery and suspected maternal depression increased the developmental delay risk, independent of virus exposure.
摘要：
背景：SARS-CoV-2妊娠暴露对儿童发育的影响尚无定论。
目的：分析SARS-CoV-2妊娠暴露对神经发育的影响，直至12个月。
方法：前瞻性队列研究于2021年8月至2022年9月在巴西东南部的五个城市进行。
方法：从新生儿筛查期间进行的血清学调查中招募婴儿，并随访至12个月大。我们包括224名在怀孕期间暴露于SARS-CoV-2的婴儿和225名未暴露的婴儿，根据新生儿的血清学结果以及其母亲和母亲的产前RT-PCR结果。
方法：在6个月和12个月时使用巴西版幼儿健康调查（SWYC-BR）进行发育评估。在6个月和12个月时怀疑发育迟缓（SDD）的儿童被认为是发育迟缓（HRDD）的高风险。此外,研究了与SDD相关的危险因素.
结果：有111名儿童患有SDD，52名儿童患有HRDD。SARS-CoV-2妊娠暴露与SDD无关。与妊娠晚期相比，妊娠早期暴露使SDD风险增加了2.15倍。剖宫产预测SDD(OR1.56;95CI1.01-2.42)和HRDD(OR1.91;95CI1.04-3.48)。此外,疑似产妇抑郁症可预测SDD(OR1.76;95CI1.01-3.10)。
结论：SARS-CoV-2妊娠暴露并未增加发育迟缓的风险。然而,我们的研究结果表明，妊娠暴露越早，12个月时发育迟缓的风险越大。剖宫产和疑似产妇抑郁症增加发育迟缓的风险，独立于病毒暴露。
目的：分析SARS-CoV-2妊娠暴露对神经发育的影响，直至12个月。
方法：前瞻性队列研究于2021年8月至2022年9月在巴西东南部的五个城市进行。
方法：从新生儿筛查期间进行的血清学调查中招募婴儿，并随访至12个月大。我们包括224名在怀孕期间暴露于SARS-CoV-2的婴儿和225名未暴露的婴儿，根据新生儿的血清学结果以及其母亲和母亲的产前RT-PCR结果。
方法：在6个月和12个月时使用巴西版幼儿健康调查（SWYC-BR）进行发育评估。在6个月和12个月时怀疑发育迟缓（SDD）的儿童被认为是发育迟缓（HRDD）的高风险。此外,研究了与SDD相关的危险因素.
结果：有111名儿童患有SDD，52名儿童患有HRDD。SARS-CoV-2妊娠暴露与SDD无关。与妊娠晚期相比，妊娠早期暴露使SDD风险增加了2.15倍。剖宫产预测SDD(OR1.56;95CI1.01-2.42)和HRDD(OR1.91;95CI1.04-3.48)。此外,疑似产妇抑郁症可预测SDD(OR1.76;95CI1.01-3.10)。
结论：SARS-CoV-2妊娠暴露并未增加发育迟缓的风险。然而,我们的研究结果表明，妊娠暴露越早，12个月时发育迟缓的风险越大。剖宫产和疑似产妇抑郁症增加发育迟缓的风险，独立于病毒暴露。
