Infant and child health outcomes following SARS-CoV-2 infection in pregnancy

New data suggest that there may be lasting effects of SARS-CoV-2 infection in pregnancy on both mothers and their children. Because of the relative recency of the pandemic, we are only now able to start investigating these issues. Current information comes from small studies that lack detailed information on the timing of COVID-19 diagnoses in pregnancy and the presence or severity of symptoms. Existing Canadian data can be used to address these knowledge gaps. This project will make use of routinely collected hospital, birth registry and public health data in Ontario to investigate the long-term impacts of COVID-19 in pregnancy on infant and child health. We will establish a large dataset of mother and infant pairs with and without documented COVID-19 in pregnancy. Within this dataset, we will investigate the association between SARS-CoV-2 infection in pregnancy and child risk of hospitalization, emergency department visits, and immune-related health care use. We will also assess the association between SARS-CoV-2 infection in pregnancy and child risk of hearing and sight deficits, speech and language delays, and neurodevelopmental disorders. In our analyses, we will account for the timing of SARS-CoV-2 infection during pregnancy, disease severity, presence of symptoms, postnatal infections, and maternal and child vaccinations. With this approach, we will have the breadth and depth of detail necessary to address critical questions about the impacts of COVID-19 on fetal development and child wellbeing and the protective role of COVID-19 vaccines for reducing risk of adverse health outcomes. We will use our findings to help inform maternity and child health care providers, health agencies and Canadian families about the potential long-term risks associated with COVID-19 in pregnancy, and support early screening and intervention of at-risk children to give them the best possible starts in life.