Maternal stress and viral illness during pregnancy are associated with neurodevelopmental conditions in offspring. Children born during the COVID-19 pandemic, including those exposed prenatally to maternal SARS-CoV-2 infections, are reaching the developmental age for the assessment of risk for neurodevelopmental conditions. We examined associations between birth during the COVID-19 pandemic, prenatal exposure to maternal SARS-CoV-2 infection, and rates of positive screenings on the Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R). Data were drawn from the COVID-19 Mother Baby Outcomes (COMBO) Initiative. Participants completed the M-CHAT-R as part of routine clinical care (COMBO-EHR cohort) or for research purposes (COMBO-RSCH cohort). Maternal SARS-CoV-2 status during pregnancy was determined through electronic health records. The COMBO-EHR cohort includes n=1664 children (n=442 historical cohort, n=1222 pandemic cohort; n=997 SARS-CoV-2 unexposed prenatally, n=130 SARS-CoV-2 exposed prenatally) who were born at affiliated hospitals between 2018-2023 and who had a valid M-CHAT-R score in their health record. The COMBO-RSCH cohort consists of n=359 children (n=268 SARS-CoV-2 unexposed prenatally, n=91 SARS-CoV-2 exposed prenatally) born at the same hospitals who enrolled into a prospective cohort study that included administration of the M-CHAT-R at 18-months. Birth during the pandemic was not associated with greater likelihood of a positive M-CHAT-R screen in the COMBO-EHR cohort. Maternal SARS-CoV-2 was associated with lower likelihood of a positive M-CHAT-R screening in adjusted models in the COMBO-EHR cohort (OR=0.40, 95% CI=0.22 - 0.68, p=0.001), while analyses in the COMBO-RSCH cohort yielded similar but non-significant results (OR=0.67, 95% CI=0.31-1.37, p=0.29). These results suggest that children born during the first 18 months of the COVID-19 pandemic and those exposed prenatally to a maternal SARS-CoV-2 infection are not at greater risk for screening positive on the M-CHAT-R.

中文翻译：

---

按大流行出生和产前 SARS-CoV-2 暴露划分的 M-CHAT-R 筛查阳性率

怀孕期间的母亲压力和病毒性疾病与后代的神经发育状况有关。在 COVID-19 大流行期间出生的儿童，包括那些在产前暴露于母亲 SARS-CoV-2 感染的儿童，正达到评估神经发育状况风险的发育年龄。我们研究了 COVID-19 大流行期间的出生、产前暴露于母亲 SARS-CoV-2 感染以及幼儿自闭症修订检查表（M-CHAT-R）阳性筛查率之间的关联。数据来自 COVID-19 母婴结局 (COMBO) 计划。参与者完成 M-CHAT-R 作为常规临床护理（COMBO-EHR 队列）或用于研究目的（COMBO-RSCH 队列）的一部分。母亲在怀孕期间的 SARS-CoV-2 状态是通过电子健康记录确定的。COMBO-EHR 队列包括 n=1664 名出生于附属医院的儿童（n=442 历史队列，n=1222 流行病队列；n=997 名产前未接触过 SARS-CoV-2，n=130 名产前接触过 SARS-CoV-2）。 2018 年至 2023 年期间的医院，并且其健康记录中具有有效的 M-CHAT-R 评分。COMBO-RSCH 队列由在同一家医院出生的 n=359 名儿童（n=268 名产前未暴露于 SARS-CoV-2，n=91 名产前暴露于 SARS-CoV-2）组成，他们参加了一项前瞻性队列研究，其中包括给予18 个月大时的 M-CHAT-R。在大流行期间出生与 COMBO-EHR 队列中 M-CHAT-R 筛查呈阳性的可能性更大无关。在 COMBO-EHR 队列的调整模型中，母亲 SARS-CoV-2 与 M-CHAT-R 筛查阳性的可能性较低相关（OR=0.40，95% CI=0.22 - 0.68，p=0.001），而分析COMBO-RSCH 队列产生了相似但不显着的结果（OR=0.67，95% CI=0.31-1.37，p=0.29）。这些结果表明，在 COVID-19 大流行的前 18 个月内出生的儿童以及那些在产前接触过母亲 SARS-CoV-2 感染的儿童，M-CHAT-R 筛查呈阳性的风险并不较高。