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 pregnant women and their offspring enrolled in the Signature project at Hospital Universitario Virgen del Rocio in Seville, Spain, between 01/01/2024 and 08/31/2022. Participants were subsequently classified into SARS-CoV-2 exposed (mild or severe COVID-19) and non-exposed groups. 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). The reference category for the odds ratio (OR) analyses was the non-infected group. In utero exposure to mild or severe COVID-19, as well as maternal stress, was not significantly associated with risk of developmental concern in any ASQ-3 subdomain at 12-month follow-up. This study highlights the need for further research with longer follow-up periods to better understand the potential long-term impact of prenatal COVID-19 exposure on offspring neurodevelopment.