Children exposed to SARS-CoV-2 in womb or as newborns may face increased social and respiratory problems

Children who were exposed to SARS-CoV-2 (COVID-19) while in the womb or as newborn babies may face greater difficulties with social skills and have more respiratory symptoms than non-exposed children, according to a new University of Bristol-led study published in eClinicalMedicine.

Previous research suggests that infants exposed to SARS-CoV-2 infection during pregnancy may have poorer lung growth and delayed early development before 12 months of age, particularly when compared with those born before the COVID-19 pandemic. However, until now, longer-term outcomes of children born during the COVID-19 pandemic, with and without exposure to SARS-CoV-2 during pregnancy or in the newborn period, remained unclear.

In this new study, in collaboration with the University of Oxford, Imperial College London and the University of Leicester, researchers sought to understand whether SARS-CoV-2 exposure during pregnancy impacted the longer-term development and breathing of babies, and whether they suffered more health problems than children who were not exposed.

To investigate this, researchers approached families looked after in 87 NHS hospitals in England and Wales to complete surveys on their child's development and respiratory health. Participants included 96 babies who were born to mothers in the SARS-CoV-2 exposed group, and 243 babies in the non-exposed comparison group. Parents were asked to complete a survey about the development and breathing problems of their children and their child's use of health care services up to their second birthday.

The team found that overall development at two years of age did not differ between the children who were exposed and not-exposed to SARS-CoV-2. However, on a group level, the exposed cohort were at greater risk of slightly delayed social-emotional development.

Importantly, children exposed to the virus in the perinatal period also had more problems with breathing and used health care services more, including more inpatient, outpatient and GP attendances by two years of age when compared with the non-exposed cohort.

Dr. Ela Chakkarapani, one of the study's lead authors, Associate Professor of Neonatal Neuroscience and Director of the Centre for Academic Child Health at Bristol Medical School explained, "Our study indicates that antenatal or neonatal exposure to SARS-CoV-2 is associated with an increased risk of social-emotional difficulties in early childhood. Social-emotional delay in infancy poses a risk for difficulties later in childhood, and may impact children's ability to develop positive peer relationships and achieve academic success.

"We can only say that children with perinatal exposure to SARS-CoV-2 might develop difficulties with social emotional development. We need larger studies and longer-term follow-up to confirm and understand this risk. If parents are concerned about their child's development after exposure to SARS-CoV-2 during pregnancy, then they should see their GP.

"Children's lung function and health care usage also needs to be monitored longer term to identify whether there is improvement as they grow older. These findings inform the health care policy for monitoring children's health with perinatal SARS-CoV-2 infection and safeguarding their health in future pandemics."