687 - Examination of Risk of Adverse Neurodevelopmental Outcomes among Infants Born During the COVID-19 Pandemic

Publication Number: 687.4842

Rebecca J.. Baer, UCSF, San Francisco, CA, United States; Scott P. Oltman, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Carrie Des Roches, University of California, Berkeley, Castro Valley, CA, United States; Audrey Lyndon, NYU Rory Meyers College of Nursing, New York, NY, United States; Safyer McKenzie-Sampson, Stanford University School of Medicine, Palo Alto, CA, United States; Larry Rand, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Kelli K. Ryckman, Indiana University, Bloomington, IN, United States; Akila Subramaniam, University of Alabama School of Medicine, Birmingham, AL, United States; Louie M. Swander, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Laura Jelliffe-Pawlowski, New York University, New York, NY, United States; Elizabeth E. Rogers, University of California, San Francisco, School of Medicine, San Francisco, CA, United States

Background: Findings have differed as to whether COVID-19 risk mitigation factors, such as facial masks, social isolation, social distancing, and vaccination adversely impacted the neurodevelopment of infants born during the pandemic.

Objective: To examine whether infants born during 2020 and 2021, when COVID-19 risk mitigation policies and practices were most used, were at increased risk of neurodevelopmental delay compared to those born in 2022.

Design/Methods: The sample included 286 mother/infant dyads in the Healthy Outcomes of Pregnancy for Everyone (HOPE) study with maternal enrollment during pregnancy and a completed infant survey at 6-, 12-, and 18-months after birth that included an Ages and Stages questionnaire. The questionnaires evaluate five developmental domains: communication, fine motor, gross motor, problem solving, and personal social. Infants were categorized as no delay, possible delay, and likely delay for each domain. Risk of possible delay or likely delay was calculated for the enrollment years 2020 and 2021 versus 2022 using Poisson log-linear regression (relative risks (RRs)). Data for five models was assessed: unadjusted; adjusted (adj)1 - demographic information; adj2 - maternal COVID infection during pregnancy; adj3 - maternal COVID vaccination during pregnancy; adj4 - maternal COVID vaccination after pregnancy.

Results: The sample included 117 mothers enrolled in 2020, 99 enrolled in 2021, and 70 enrolled in 2022. The sample was predominately white, non-Hispanic (71.7%) and 53.5% resided in California. All had more than 12 years of education, and 44.4% had a household income of $200,000 or more. Preterm birth occurred in 6.5% of infants, 9.1% were small for gestational age, and 24.9% of infants had a COVID-19 infection in the first 18 months of life. In unadjusted models and adjusted models, infants born to mothers who enrolled in 2020 or 2021 were not more likely to have a likely or possible delay across most domains at any time period compared to those enrolled in 2022. One exception was for problem solving at 12-months which, after adjusting for maternal COVID vaccination after pregnancy, was found to be significantly more likely in those born in 2020 compared to 2022 (15 (16.1%) versus 3 (4.9%), aRR 3.8, 95% confidence interval 1.1 to 13.3). The difference was no longer noted at the 18-month follow-up.

Conclusion(s): Infants born at differing times during the COVID-19 pandemic had mostly similar patterns of neurodevelopment at 6-, 12-, and 18-months suggesting minimal impact of pandemic-related restrictions on the measured neurodevelopmental outcomes in this cohort.