To examine the prevalence of neurodevelopmental delays in premature infants exposed to SARS-CoV-2 in-utero.

Previous investigations of neonatal outcomes of COVID-19 have found preterm birth, fetal distress, and intrauterine growth retardation to be common in this patient population, but few studies have studied how in-utero exposure to SARS-CoV-2 impacts premature infant neurological development.

Retrospective analysis of 180 NICU patients found 7 premature infants born to mothers who tested positive for SARS-CoV-2 during pregnancy. Developmental outcomes were compared between premature infants exposed to SARS-CoV-2 in-utero and premature infants not exposed to SARS-CoV-2 in-utero.

Of the extreme preterm NICU infants (< 28 weeks) exposed to SARS-CoV-2 in-utero, 50% had developmental delays and 50% had gross motor delays compared to 44.3% and 15.2% in extreme preterm NICU infants not exposed to SARS-CoV-2 in-utero respectively. In moderately preterm NICU infants (28-31 weeks) exposed to SARS-CoV-2 in-utero, the rates of developmental delay, gross motor delay, motor delay, and speech delay, were each found to be 50% compared to moderately preterm NICU infants not exposed to SARS-CoV-2 in-utero whose rates were 46.4% (developmental delay), 23.3% (gross motor delay), 6.67% (speech delay), and 10.0% (motor delay). No increases in developmental delay, gross motor delay, motor delay, or speech delay were found in later preterm NICU infants (32-26 weeks) exposed to SARS-CoV-2 in-utero compared to later preterm NICU infants not exposed to SARS-CoV-2 in-utero.

Developmental and gross motor delays may be increased in extremely preterm and moderately preterm NICU infants exposed to SARS-CoV-2 in-utero compared to infants not exposed to SARS-CoV-2 in-utero. Rates of motor delay and speech delay may also be elevated in the moderately preterm category for NICU infants exposed to SARS-CoV-2 in-utero compared to infants not exposed to SARS-CoV-2 in-utero. Further studies would be needed to evaluate this detail.