Prenatal Maternal COVID-19 and Offspring Risk for Morbidities Up to the Age of One Year

Background: Prenatal maternal coronavirus disease 2019 (COVID-19) infection may worsen the clinical course of the disease and increase the risk for adverse obstetric and neonatal outcomes depending on the severity of the disease and timing of exposure. Data regarding the long-term impact on offspring exposed to prenatal maternal COVID-19 are still limited. Objective: To study the association between prenatal maternal COVID-19 infection and offspring risk for infectious diseases, respiratory complications, and developmental delay up to the age of 1 year. Study design: A retrospective cohort study was conducted. The study included 19,050 women-offspring dyads who delivered at the Soroka University Medical Center between December 30, 2020, and July 30, 2022, of them, 2663 (14%) women were diagnosed with COVID-19 infection during pregnancy. Pregnancy, delivery and offspring complications were compared between women who were diagnosed with COVID-19 infection during pregnancy and women who were not. Multivariable logistic regression models were performed to examine the association between maternal prenatal COVID-19 infection selected offspring diagnoses, while adjusting for background characteristics, and among exposed offspring, to compare the incidence of offspring diagnoses based on trimester of maternal infection. Results: Offspring of mothers with prenatal COVID-19 infections were at higher risk for viral infections [adjusted odds ratio (OR) = 1.167; 95% CI = 1.028–1.325, P = 0.017], specifically among offspring exposed during the third trimester. The risk for viral infections was lower in cases where the mothers were diagnosed with COVID-19 during the second trimester. These offspring were specifically at increased risk for COVID-19; however, only if the mothers were infected during the third trimester. The risk for offspring COVID-19 was lower if the mothers were diagnosed earlier during pregnancy. No associations were observed with the risk for developmental delay (0.8% vs. 1.1%, OR = 0.724, 95% CI = 0.46–1.14, P = 0.161) or respiratory complications (3.3% vs. 4%, OR = 0.83, 95% CI = 0.662–1.041, P = 0.107). Conclusions: Offspring exposed to maternal COVID-19 infection were at increased risk for viral and COVID-19 infections up to the age of 1 year old, specifically if the mothers were infected during late third trimester. Offspring exposed to maternal COVID-19 infection earlier during gestation were at lower risk for viral infections including COVID-19 in the first year of life.