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Oral Concurrent Session 9 - Medical Complications

Oral Concurrent Sessions

Oral Concurrent Session 9 - Medical Complications

(101) Neurodevelopmental outcomes of 3-year-old children of mothers with SARS-CoV-2 infection in pregnancy

Saturday, February 1, 2025
9:30 AM – 9:45 AM  
Location: Aurora Ballroom CD, Lobby Level
Objective: Large epidemiologic studies have demonstrated an increased risk for neurodevelopmental diagnoses (ND) after maternal viral infection in pregnancy. We previously reported an increased risk of ND in offspring exposed to SARS-CoV-2 in utero up to 18 months after birth. We sought to determine whether increased risk of offspring ND after maternal SARS-CoV-2 infection persisted at 3 years of age.

Study Design: Retrospective cohort study of live offspring of all mothers who delivered between March 1, 2020 and May 31, 2021 at 8 hospitals across 2 health systems in Massachusetts. The exposure of interest is a positive SARS-CoV-2 PCR during pregnancy. The primary outcome is electronic health record documentation of one or more ICD-10 diagnostic codes corresponding to ND in offspring. Linear regression models were constructed adjusting for race/ethnicity, insurance status, hospital type, maternal age, and preterm birth.

Results: The cohort included 18,124 live births including 861 (4.8%) with maternal SARS-CoV-2 in pregnancy – Table 1. In regression models, maternal SARS-CoV-2 was associated with a statistically significant elevation in risk for offspring ND at 3 years (139/861 [16.1%] exposed vs 1653/17,263 [9.6%] unexposed); adjusted odds ratio (aOR) 1.30 [95% CI 1.06-1.58]; P = .01 – Figure 1. The most common NDs were speech/language and motor function disorders. In sex-stratified models, effects were larger in males (aOR 1.38 [1.06-1.77]; p=.01) compared to females (aOR 1.20 [0.86-1.64]; p=.3). Effect was larger in 3rd-trimester exposure (aOR 1.36 [1.06-1.71]; p=.01) vs 1st and 2nd trimester exposures (aOR 1.15 [0.83-1.58]; p=.38).

Conclusion: In this large cohort, maternal SARS-CoV-2 infection was associated with significantly increased risk for ND among 3-year-old children, with a stronger impact on male compared to female offspring and greater effects noted after 3rd-trimester exposure. Larger cohorts and longer-term follow-up with more ND accrued will be required to reliably estimate risk and examine impact of trimester of infection and prior vaccination.