Desenvolvimento Neuropsicomotor de bebês nascidos de mães contaminadas e não contaminadas pelo vírus SARS-CoV-2 no período gestacional

Abstract

Introduction: A novel type of virus, named SARS-CoV-2, triggered the 2019 coronavirus disease (COVID-19), which was declared a pandemic by the World Health Organization in 2020. Other viral infections with maternal-fetal risks have previously been reported, such as the Zika virus, which led to an increase in cases of microcephaly in infants born to mothers infected during pregnancy. This highlights the importance of monitoring infants born to mothers infected with SARS-CoV-2 during pregnancy, as the long-term impacts on this group remain uncertain. This raises the question: do infants exposed to SARS-CoV-2 in utero exhibit alterations in neuropsychomotor development during the first years of life? Objective: To evaluate the neuropsychomotor development of infants born to mothers infected with SARS CoV-2 during pregnancy, compared to those born to uninfected mothers during the same period, between 18 and 24 months of age. Methods: This is a quantitative, epidemiological, analytical observational study with a cross-sectional design, conducted in the municipality of Cascavel, Paraná, Brazil. The sample was divided into two groups: Group 01, composed of 19 children born to mothers infected with SARS CoV-2 during pregnancy (Exposed Group - EG); and Group 02, composed of 31 children born to mothers who were not infected with SARS-CoV-2 (Non-Exposed Group - NEG). Participants were randomly selected from municipal health information systems covering the period from March 2020 to December 2021, and assessment appointments were scheduled accordingly. Data collection took place from October 2022 to September 2023 and involved a structured interview with the mother or legal guardian (including demographic, social, and health-related information), using a validated instrument. Neuropsychomotor development was assessed using the Bayley Scales of Infant and Toddler Development – Third Edition (Bayley-III) and the Ages and Stages Questionnaire – Third Edition (ASQ-3, Brazilian version). Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) and JASP software. Statistical tests were selected according to data distribution and included Fisher’s Exact Test, Chi-Square Test with Yates’ correction, and Student’s T-test. Results: The characterization instrument used for the sample demonstrated a content validity index of 0.85, indicating strong content equivalence. When comparing the Bayley-III and ASQ-3 scales for assessing infant neuropsychomotor development, moderate correlations were observed between the "communication" domains (r = 0.535, p < 0.001). However, these findings were not sufficient to confirm equivalence between the two instruments. Neuropsychomotor development outcomes showed no statistically significant differences between the NEG and EG groups across both assessment tools (Bayley-III: p = 0.39; ASQ-3: p = 0.21 to 0.85 across domains). Conclusions: Infants born to mothers who tested positive for SARS-CoV-2 during pregnancy did not demonstrate significant neuropsychomotor developmental alterations between 18 and 24 months of age when compared to those born to SARS CoV-2 negative mothers.