@article{Hardie_I-2025_195349,
title = {Early childhood developmental concerns following SARS-CoV-2 infection and COVID-19 vaccination during pregnancy: A Scottish population-level retrospective cohort study},
author = {Hardie, I. and Marryat, L. and Murray, A. and King, J. and Okelo, K. and Boardman, J. and Lombardo, M. and Stock, S. and Wood, R. and Auyeung, B.},
month = {feb},
year = {2025},
abstract = {Background: Understanding the effects of SARS-CoV-2 infection and COVID-19 vaccination during pregnancy can help inform clinical guidance and tackle vaccine hesitancy. We examined relationships between SARS-CoV-2 infection during pregnancy, COVID-19 vaccination during pregnancy, and early child developmental concerns in Scotland. Methods: We created a large population-level linked administrative health dataset, combining the COVID-19 in Pregnancy in Scotland (COPS) dataset with 13-15 month child health review data and other datasets. This included children conceived after 18th May 2020 and born before 30th September 2021, and their mothers. Logistic regression modelling investigated associations between SARS-CoV-2 infection during pregnancy, COVID-19 vaccination during pregnancy, and developmental concerns (i.e. parent or caregiver developmental concerns and health visitor identified concerns regarding speech-language-communication, problem-solving, gross-motor, personal-social, emotional-behavioural development) measured during 13-15 month health reviews, including adjustment for confounders and covariates.  Findings: N=24,919 child-mother pairs (12,752 male children (51.2%); 12,167 female children (48.8%)). 1,631 children (6.6%) were prenatally exposed to SARS-CoV-2 and 4,943 (19.8%) to COVID-19 vaccination. We found no associations between SARS-CoV-2 infection during pregnancy and developmental concerns. After confounder and covariate adjustment, COVID-19 vaccination during pregnancy was associated with reduced odds of developmental concerns regarding problem-solving (OR: 0.78; 95% CI: 0.64-0.95), personal-social (OR: 0.76; 95% CI: 0.61-0.95) and emotional-behavioural (OR: 0.67; 95% CI: 0.48-0.92) development, but had no associations with other concerns.  Interpretation: SARS-CoV-2 infections during pregnancy do not appear to be linked to early childhood developmental concerns, and COVID-19 vaccinations during pregnancy are safe from the perspective of early childhood developmental concerns. As some developmental concerns do not become apparent until children are older than 13-15 months, future research should continue to monitor outcomes as children get older.},
pages = {162-171},
volume = {9},
issue = {3},
journal = {The Lancet Child & Adolescent Health},
publisher = {Elsevier},
url = {https://doi.org/10.1016/S2352-4642(25)00008-2},
}
