Abstract Rationale The development of asthma, and its precursor, recurrent wheezing episodes during early childhood is multi-factorial. Viral infections during pregnancy have the potential to affect fetal lung development and have been linked to the frequency of wheezing in offspring. The onset of the global COVID-19 pandemic led to the infection of millions of pregnant persons and subsequently produced an entire generation of children prenatally exposed to SARS-Cov-2. The primary aim of this study was to investigate the association between maternal SARS-CoV-2 infection during pregnancy and wheezing in the first 4 years of life in their offspring. Methods Data for this prospective cohort study were drawn from the COVID-19 Mother Baby Outcomes (COMBO) Initiative which enrolled mothers with and without positive SARS-CoV-2 tests at the time of delivery and followed children with periodic surveys about health outcomes. Survey data was obtained regarding socio-economic status, gestational age, sex, atopy, maternal asthma status, and wheezing episodes for 344 children. Recurrent wheeze was defined as 2 or more lifetime episodes of wheezing. A covariate-adjusted generalized linear model was developed to determine the effect of SARS-CoV-2 exposure on development of recurrent wheeze when adjusting for sex, gestational age, socioeconomic status, atopy, and maternal asthma. Results The study population included 133 children born to mothers with SARS-CoV-2 during pregnancy and 211 children born to mothers without SARS-Co-V2 during pregnancy. The groups were similar in terms of sex, gestational age, and atopy however the SARS-CoV-2 exposed population was significantly more likely to be Hispanic and of lower socioeconomic status (Table 1) There was no effect of prenatal SARS-CoV-2 exposure on the development of recurrent wheezing at 2 (OR = 1.23, 95% CI: 0.56-2.64) , 3 (OR = 0.92, 95% CI: 0.51-1.64), or 4 (OR-1.17, 95% CI: 0.60-2.27, p = 0.635) years of age. We identified a previously published connection between development of recurrent wheeze and maternal asthma at 2 (OR = 3.89, 95% CI: 1.65-8.99) and 3 (OR = 2.79, 95% CI:1.41-5.40) years of age. Conclusions We found no association between maternal SARS-CoV-2 and the development of recurrent wheeze; however, we did identify a previously reported linkage between recurrent wheeze and maternal asthma. The significance of this negative finding is reinforced by the fact that we were able to identify known factors attributing to development of recurrent wheeze. Future work includes longer follow up of the cohort to determine effects of SARS-CoV-2 exposure in utero on asthma and lung function. This abstract is funded by: by Columbia University Department of Pediatrics Innovation Nucleation Fund to MK
Longley et al. (Fri,) studied this question.