Antenatal and neonatal exposure to SARS-CoV-2 and children’s development: a systematic review and meta-analysis

Objectives

To conduct a systematic review of the impact of antenatal and neonatal exposure to SARS-CoV-2 on developmental outcomes in preterm and term-born infants.

Methods

We searched Embase, Emcare, MEDLINE, PsycINFO, Web of Science and grey literature on May 27, 2022 and updated on May 8, 2023. Studies defining exposure with a positive SARS-CoV-2 protein or genetic material, used a contemporaneous non-exposed cohort, and reported developmental outcomes up to 2 years of age were included.  

Results

Four out of 828 screened studies were included. Meta-analysis included815 infants screened fordevelopmental  delay  (n=306  exposed;   n=509  non-exposed)  between  3-  and  11-months  of  age.Among term-born infants, we did not find an increased risk of delay in communication (odd’s ratio:0.73 (95% CI: 0.24 to 2.24)), gross motor (1.50 (0.62, 3.62)), fine motor (2.90 (0.58, 14.43)), problem-solving (1.19 (0.54, 2.66)) or personal-social development (1.93 (0.78, 4.75)) in exposed infants. Thenumber of preterm-born infants in the exposed (n=37) and comparison cohorts (n=41) were too fewto report meaningful comparisons. Conclusion

Evidence regarding the potential impact of antenatal or neonatal exposure to SARS-CoV-2 infectionon   developmental   outcomes   in   early   infancy   is   limited   and   inconsistent.   Larger   cohorts   withoutcomes beyond the first year of life are needed.