Langzeit-Outcome von Säuglingen und Kleinkindern von mit SARS-CoV-2 infizierten Schwangeren - eine Pilotstudie des Post-CRONOS-Projekts
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The COVID-19 pandemic was an unprecedented event in recent world history. Many questions about the consequences of the disease remain unanswered. It is already known that pregnant women infected with SARS-CoV-2 are at risk of severe disease progression. Initial studies have shown that infants exposed to SARS-CoV-2 may develop neurological abnormalities. However, to date there has been no systematic data basis for this topic in Germany, which is why this study sought to answer the questions of whether developmental milestones were reached on time in infants exposed to SARS-CoV-2 in utero, whether regulatory disorders occurred, whether preventive medical check-ups and vaccinations were carried out on time, and whether any abnormalities were found. In addition, questions were asked about the nutritional situation. These empirical data were compared with available pre-pandemic data. The data was collected using a webbased questionnaire fed into the browser-based application REDCap®. The
questionnaire comprised 36 items and consisted of six sections: 1. General information on child development, 2. Nutrition,
3. Preventive care and vaccinations, 4. Outpatient doctor's appointments, 5. Inpatient treatments, 6. Regulatory disorders. The study group consisted of infants/children of women who tested PCR positive for SARS-CoV-2 during pregnancy, who were included in the CRONOS registry study and who had already agreed to be contacted again. These women form the Post-CRONOS cohort. A total of 773 women were contacted for the survey, of whom 110 responded to the questionnaire (14%). Their 110 children form the population of this study. In the present study, all mothers were subjectively satisfied with their children's development. The developmental milestones were achieved as expected (grasping: median 4 months, crawling: median 8 months, sitting: median 8 months, walking: median 13 months, first words: median 12 months). There was no increased rate of children showing signs of de
velopmental delay in this regard. However, increased regulatory symptoms were observed in the cohort studied, particularly in relation to excessive crying and feeding disorders. Excessive crying was reported by 50.9% of respondents, difficulty falling asleep by 13.6%, difficulty staying asleep by 4.5% and feeding difficulties by 31.8% of respondents. The U2 preventive medical check-ups took
place on time, but there was a delay in 10% of cases for the U3 check-ups. There was also a significant deficit in terms of the timing of vaccinations (30.2% delay) and the vaccines administered (43.6% 6-fold vaccination). In terms of nutrition, no disadvantage was found in children exposed to SARS-CoV-2 in utero, from which it can be concluded that the women were adequately informed about the lack of SARS-CoV-2 infection risk through breast milk. There is also evidence that the pandemic played a decisive role in delays in preventive medical checkups and vaccinations. As this study is to be understood as a pilot study, it provides starting points for
future studies. On the one hand, it is advisable to supplement objective developmental diagnostics with a perspective on the subjective timely achievement of developmental milestones. Furthermore, it seems sensible to observe the child's development over a longer period of time and to classify their regulatory ability in the psychosocial context of the family. Studies that build on or follow up on the results of the present work can contribute to this.
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