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Meta-Analysis
. 2022 Oct 3;5(10):e2238941.
doi: 10.1001/jamanetworkopen.2022.38941.

COVID-19 Pandemic and Infant Neurodevelopmental Impairment: A Systematic Review and Meta-analysis

Kamran Hessami  1 , Amir Hossein Norooznezhad  2 , Sonia Monteiro  3 , Enrico R Barrozo  4 , Abolfazl Shirdel Abdolmaleki  5 , Sara E Arian  6 , Nikan Zargarzadeh  7 , Lara S Shekerdemian  8 , Kjersti M Aagaard  4 , Alireza A Shamshirsaz  1
Affiliations
Meta-Analysis

COVID-19 Pandemic and Infant Neurodevelopmental Impairment: A Systematic Review and Meta-analysis

Kamran Hessami et al. JAMA Netw Open. .

Abstract

Importance: Primary studies proposed that aberrant maternal antiviral immunity and/or giving birth in quarantine, such as during the ongoing COVID-19 pandemic, may be associated with the risk of neurodevelopmental impairment (NDI) in offspring.

Objectives: To evaluate the associations of birth and being raised during the COVID-19 pandemic with risk of NDI among infants and to assess the association of gestational exposure to SARS-CoV-2 with risk of NDI.

Data sources: PubMed, Web of Science, Scopus, Embase, and preprint servers were systematically searched from inception to March 25, 2022.

Study selection: Studies evaluating the neurodevelopment of infants born during the SARS-CoV-2 pandemic were included in this systematic review and meta-analysis. Studies using Ages and Stages Questionnaires, Third Edition (ASQ-3), were used for quantitative meta-analysis.

Data extraction and synthesis: Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses, a random-effects model meta-analysis was used to pool the proportion and odds ratios (ORs) of overall NDI, as well as each developmental domain on ASQ-3 with the corresponding 95% CI.

Main outcomes and measures: The primary outcome was the risk of overall NDI among infants screened during the pandemic vs prepandemic. The secondary outcome was the comparison of NDI by ASQ-3 domain among infants born to women with known gestational exposure to SARS-CoV-2 vs no exposure.

Results: A total of 8 studies were included, including 21 419 infants (11 438 screened in pandemic and 9981 in prepandemic period). NDI was present in 330 of 8992 infants (7%; 95% CI, 4%-10%) screened during the COVID-19 pandemic from January 2020 to January 2021. Among the pandemic cohort, the prevalence of NDI among infants with gestational exposure to SARS-CoV-2 was 77 of 691 (12%; 95% CI, 6%-18%). Compared with the prepandemic cohort (2015-2019), the pandemic cohort was more likely to have communication impairment (OR, 1.70; 95% CI, 1.37-2.11; P < .001), without significant differences in other ASQ-3 domains (eg, gross motor, fine motor, personal-social, and problem-solving). In contrast, maternal SARS-CoV-2 infection was not associated with significant differences in any neurodevelopment domain in offspring, except for increasing the odds of fine motor impairment (OR, 3.46; 95% CI, 1.43-8.38; P < .001).

Conclusions and relevance: In this systematic review and meta-analysis examining the association between COVID-19 pandemic and the risk of NDI, findings suggest that overall neurodevelopment in the first year of life was not changed by either being born or raised during the SARS-CoV-2 pandemic or by gestational exposure to SARS-CoV-2. Interestingly, the first year of life during the COVID-19 pandemic, regardless of maternal infection, was significantly associated with the risk of communication delay among the offspring.

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Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.
Figure 1.. Study Flowchart
Figure 2.
Figure 2.. Prevalence of Risk for Neurodevelopmental Impairment (NDI) Among Infants Screened During the Pandemic, In Utero SARS-CoV-2–Exposed Cohort, and In Utero SARS-CoV-2–Unexposed Cohort
Analyses used a random-effects DerSimonian Laird model.
Figure 3.
Figure 3.. Meta-analysis of Overall Risk of Neurodevelopmental Impairment and Gross Motor, Fine Motor, and Personal-Social Domains Among Infants Screened During Pandemic vs Before Pandemic
Analyses used a random-effects DerSimonian Laird model.
Figure 4.
Figure 4.. Meta-analysis of Overall Risk of Neurodevelopmental Impairment (NDI) and Gross Motor, Fine Motor, and Personal-Social Domains Among In Utero Exposed vs Unexposed Pandemic-Born Cohorts
Analyses used a random-effects DerSimonian Laird model.
See this image and copyright information in PMC

Comment in

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