The Impact of the COVID-19 Pandemic on Communication in Infants

Infants are at higher risk for communication impairment and personal-social impairment if they were born or raised during the COVID-19 pandemic.

Risk of communication impairment significantly increased in infants born and raised during the COVID-19 pandemic, according to study findings published in JAMA Network Open.

Researchers in the United States conducted a systematic review and meta-analysis to assess the associations of birth and upbringing during the COVID-19 pandemic as well as gestational exposures to COVID with risk for neurodevelopmental impairments. They searched through the literature published on the PubMed, Web of Science, Scopus, Embase, and preprint server databases from inception to March 25, 2022.

The researchers identified 8 eligible studies including a total of 21,419 infants; 9981 infants were screened before the pandemic between 2015 and 2019 and 11,438 screened during the pandemic.

Between January 2020 and January 2021 during the COVID pandemic, 330 of 8992 screened infants demonstrated neurodevelopmental impairments (7%; 95% CI, 4%-10%). Among the infants born during the pandemic, gestational exposure to COVID-19 occurred in 691 infants with 77 of these 691 presenting with neurodevelopmental impairments (12%; 95% CI, 6%-18%).

… [T]he first year of life during the COVID-19 pandemic, regardless of maternal infection, was significantly associated with the risk of communication delay among the offspring.

Infants born and raised during the pandemic demonstrated increased risk for communication impairment compared with infants in the prepandemic group (odds ratio [OR], 1.70; 95% CI, 1.37-2.11; P <.001).

According to scores on the Ages and Stages Questionnaires, Third Edition (ASQ-3), no differences between infant groups occurred in the following:

  • Gross motor development (OR, 1.10; 95% CI, 0.84-1.43; P =.49),
  • Fine motor development (OR, 1.41; 95% CI, 0.84-2.37; P =.20),
  • Personal-social development (OR, 1.20; 95% CI, 0.82-1.77; P =.34)
  • Problem-solving (OR, 0.97; 95% CI, 0.79-1.19; P =.75)

When analyzing subgroups according to infant age at neurodevelopmental screening, infants screened at age 12 months who were born and raised during the pandemic demonstrated higher likelihood of communication impairment (OR, 1.86; 95% CI, 1.15-3.00; P =.01) and personal-social impairment (OR, 1.55; 95% CI, 1.22-1.96; P <.001).

While most neurodevelopmental areas remained unaffected, the risk of impairment in fine motor skills increased in babies exposed to maternal COVID-19 infection while in utero compared with infants who had no exposure (OR, 3.46; 95% CI, 1.43-8.38; P =.006).

“Overall neurodevelopment in the first year of life was not changed by either being born or raised during the [COVID-19] pandemic or by gestational exposure to [COVID-19],” the researchers noted. “Interestingly, the first year of life during the COVID-19 pandemic, regardless of maternal infection, was significantly associated with the risk of communication delay among the offspring,” they concluded.

Study limitations included heterogeneity of outcome measures, the reliance on parent-reported outcomes on the ASQ-3 questionnaires rather than objective assessments, and lack of data regarding the prevalence of social distancing among affected compared with infants who were unaffected.

This article originally appeared on Neurology Advisor


Hessami K, Norooznezhad AH, Monteiro S, et al. COVID-19 pandemic and infant neurodevelopmental impairment: a systematic review and meta-analysis. JAMA Netw Open. Published online October 28, 2022. doi:10.1001/jamanetworkopen.2022.38941