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Study finds slight developmental lag in babies born during pandemic

Infants born in March to December 2020 scored lower on a test of motor and social skills at 6 months. It’s unclear whether the discrepancy will remain in the long term.

Babies born during the early months of the pandemic scored slightly lower on a screening of their developmental skills than those born prior to the pandemic, regardless of whether their mothers had Covid-19 during pregnancy, a study published Tuesday revealed. 

The study, in JAMA Pediatrics, followed 255 babies born in March to December 2020 in New York City, which was the U.S. epicenter in the pandemic’s early days. 

The infants were screened for social, communication and motor skills at 6 months of age using a standard questionnaire about their ability to roll from their back to their stomach, how often they babble and other milestones. 

In most areas, the babies born during the pandemic displayed lower scores compared to those born earlier. That held true whether they were born to mothers who had been infected with Covid during pregnancy or not, the researchers found.

The results may not be indicative of long-term lags in development, they added. 

The differences were small discrepancies in average scores between babies born before and after the pandemic began, not higher incidences of developmental delays.

And while scores in social skills and fine and gross motor skills were lower among the babies born during the pandemic, scores in communication skills were a bit higher.

“It does, of course, give pause. Why the heck are these kiddos scoring less well on what I would consider very foundational skills, like motor skills, particularly?” said Sean Deoni, an associate professor of pediatrics research at Brown University, who has conducted research on the cognitive skills of children born during the pandemic but was not involved in the JAMA Pediatrics study. 

He said he would have expected to see an effect on babies’ communication because adults’ masks hide their mouths when they talk and infants have had limited social interaction due to lockdowns.

“My initial impression would be things like language would be affected and motor wouldn’t be, and we’re seeing the opposite,” Deoni said.

All of the participants were born at the NewYork-Presbyterian Morgan Stanley Children’s Hospital or the NewYork-Presbyterian Allen Pavilion Hospital, and their scores were compared to those of 62 infants born at the same hospitals before the pandemic began who were also tested at 6 months old.

The researchers speculated that stress pregnant women experienced due to the pandemic could explain the drop in babies’ motor and social skills.

But lead study investigator Dr. Dani Dumitriu, an assistant professor of pediatrics and psychiatry at Columbia University and a newborn hospitalist at the Morgan Stanley Children’s Hospital, said it was likely due to several factors. The effects of being born into an environment of lockdowns and other pandemic-related stressors on families that interrupted childhood, such as job loss or unstable housing, probably contributed, too, she said.

She called the findings a “huge surprise,” particularly because researchers did not find lower scores among infants whose mothers had Covid while they were pregnant, compared to babies born during the pandemic to mothers who didn’t get infected.

“We expected there to be a difference based on what’s known from other viruses,” she said. 

Mollie Wood, an assistant professor of epidemiology at the University of North Carolina Gillings School of Global Public Health and the lead author of an editorial published alongside the JAMA Pediatrics study, cautioned that pregnant women should not see these findings as reason to opt out of getting vaccinated and the booster shot or to stop wearing masks. She also said the study had limitations.

“It’s a very small sample, taken from a very specific health system in New York City, taken during a very limited time period,” she said. “Not that we can’t learn from things that way, but it does speak to a very small slice of the pandemic among pregnant people.”

While studies on how Covid might affect unborn babies’ development are still emerging, there is ample evidence of other risks that the illness poses to them. Pregnant women with Covid are more likely to deliver prematurely, which can lead to lifelong disabilities for their children, such as cerebral palsy. The virus also raises the risk of stillbirths among pregnant women, although the overall rate is still low.

What this could mean for the future

It’s not clear what the implications are of the results from the six-month screening.

“Six months is a very early developmental time point. It is not a good predictor of long-term outcomes,” Dumitriu said. “It’s a good predictor of what’s happening in the moment.”

But gathering this data early is crucial because it provides a “tremendous opportunity to intervene” should it become apparent that there are long-term deleterious effects on some children as a result of the pandemic, she said.

“Six months is a very early developmental time point. It is not a good predictor of long-term outcomes.”

lead study investigator Dr. Dani Dumitriu

“Six-month-old brains are extremely malleable and plastic, so we can already start talking at a public health level about what to do and potentially mitigate any long-term impact,” Dumitriu said.

Deoni, whose research in August 2021 found that reduced interactions due to lockdowns led to lower cognitive skills in children born during the pandemic, said the study was “super important.” 

“If things continue as they are, there will be a set of children entering into day cares, preschool and school that may have greater need than we are used to,” he said.

But he emphasized that families are not powerless. Infants’ brains, he said, are resilient, and the most important action parents can take is to be involved in their children’s day-to-day lives. Reading to children nightly is a great way to connect with them and help them grow, he said.

“If your parents are being very interactive with you, if they’re talking to you, playing with you, engaging with you, getting on the floor,” he said, “it’s going to pay dividends.”

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