Impact of Maternal Stress and COVID-19 Exposure During Pregnancy on Offspring Neurodevelopment: Signature Cohort 12 Month Follow-Up

The COVID-19 pandemic brought unprecedented global challenges. Amid the crisis, the potential impact of COVID-19 exposure on the neurodevelopment of offspring born to infected mothers emerged as a critical concern. This is a prospective cohort study of offspring exposed to mild or severe COVID-19 during pregnancy. Pregnant women who acquired SARS-CoV-2 were enrolled in the SIGNATURE project at Hospital Universitario Virgen del Rocio in Seville, Spain, between 01/01/2021 and 08/31/2022. Maternal stress was assessed through the Perceived Stress Scale; offspring neurodevelopment was screened through Ages & Stages Questionnaire, 3rd Edition (ASQ-3) at 6 months and 12 months. Association between COVID-19 severity and neurodevelopmental outcomes were analyzed with univariate and multivariate analysis. The cohort included 689 women categorized into three distinct groups based on COVID-19 severity: non-infected mothers (N = 277), mothers with mild COVID-19 (N = 358), and mothers with severe COVID-19 (N = 54). In utero exposure to severe COVID-19 infection nearly tripled the risk of developmental concern in the ASQ-3 personal-social subdomain at 12 months follow-up [OR = 2.751 (95% CI 1.065–7.106), p = 0.037], independently of the timing of the infection and maternal stress. While this study did not yield statistically significant results, it highlights the need to further investigate the potential association between COVID-19 during pregnancy and offspring neurodevelopment to understand the potential long-term consequences of prenatal COVID-19 exposure.