Impact of COVID-19 pandemic on neurodevelopmental outcomes of premature infants: a retrospective national cohort study

Objective To compare the neurodevelopmental outcomes of preterm infants before and during the COVID-19 pandemic. Design Premature infants born in 2018 were assigned to the pre-pandemic group, while those born in 2019 were assigned to the during-pandemic group. Setting Nationwide cohort study. Patients Very low birthweight premature infants registered in the Taiwan Premature Infant Follow-up Network database. Interventions Anti-epidemic measures, including quarantine and isolation protocols, social distancing, the closure of public spaces and restrictions on travel and gatherings during COVID-19 pandemic. Main outcome measures Outcomes were measured by Bayley Scales of Infant and Toddler Development Third Edition at corrected ages of 6, 12 and 24 months old. Generalised estimating equation (GEE) was applied to incorporate all measurements into a single model. Results Among the 1939 premature infants who were enrolled, 985 developed before the pandemic, while 954 developed during the pandemic. Premature infants whose development occurred during the pandemic exhibited better cognitive composite at the corrected age of 6 months (beta=2.358; 95% CI, 1.07 to 3.65; p<0.001), and motor composite at corrected ages of 12 months (beta=1.680; 95% CI, 0.34 to 3.02; p=0.014). GEE analysis showed that infants who had grown during the pandemic achieved higher scores in cognitive composite (beta=1.416; 95% CI, 0.36 to 2.48; p=0.009). Conclusion Premature infants in Taiwan who developed during the pandemic showed better neurodevelopment compared with those born before the pandemic.