Article Text

Social communication skill attainment in babies born during the COVID-19 pandemic: a birth cohort study
  1. Susan Byrne1,2,3,
  2. Hailey Sledge1,
  3. Ruth Franklin1,
  4. Fiona Boland4,
  5. Deirdre M Murray5,
  6. Jonathan Hourihane1,3,5
  7. on behalf of the CORAL Study group
    1. 1Department of Paediatrics and Child Health, Royal College of Surgeons in Ireland, Dublin, Ireland
    2. 2FutureNeuro SFI Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
    3. 3Children's Health Ireland, Dublin, Ireland
    4. 4Data Science Centre, School of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland
    5. 5INFANT Centre, Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
    1. Correspondence to Dr Susan Byrne, Paediatrics and Child Health, University of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland; suabyrne{at}


    Introduction The SARS-CoV-2 (COVID-19) pandemic was managed with sustained mass lockdowns to prevent spread of COVID-19 infection. Babies born during the early stages of the pandemic missed the opportunity of meeting a normal social circle of people outside the family home.

    Methods We compared 10 parentally reported developmental milestones at 12-month assessment in a cohort of 309 babies born at the onset of the pandemic (CORAL cohort) and 1629 babies from a historical birth cohort (BASELINE cohort recruited between 2008 and 2011).

    Results Compared with a historical cohort, babies born into lockdown appeared to have some deficits in social communication. Fewer infants in the pandemic cohort had one definite and meaningful word (76.6% vs 89.3%), could point (83.8% vs 92.8%) or wave bye-bye (87.7% vs 94.4%) at 12-month assessment. Adjusted log-binomial regression analyses demonstrated significant differences in social communication in the CORAL cohort compared with the BASELINE cohort: one definite and meaningful word (relative risk (RR): 0.86 (95% CI: 0.80 to 0.92)), pointing (RR: 0.91 (95% CI: 0.86 to 0.96)) and waving bye-bye (RR: 0.94 (95% CI: 0.90 to 0.99)).

    Discussion Parentally reported developmental outcomes in a birth cohort of babies born into lockdown during the COVID-19 pandemic may indicate some potential deficits in early life social communication. It must be noted that milestones are parentally reported and comparison is with a historical cohort with associated limitations. Further studies with standardised testing is required to validate these findings.

    Conclusion Pandemic-associated social isolation may have impacted on the social communication skills in babies born during the pandemic compared with a historical cohort. Babies are resilient and inquisitive by nature, and it is hoped that with societal re-emergence and increase in social circles, their social communication skills will improve.

    • Infant Development
    • Covid-19
    • Child Development

    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplemental information. Not applicable.

    This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplemental information. Not applicable.

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    • Correction notice This article has been corrected since it first published. The open access licence type has been changed to CC BY. 17th May 2023.

    • Collaborators CORAL Study group: Liam O’Mahony (APC UCC), Naomi McCallion (Rotunda Hospital Dublin and Department of Paediatrics and Child Health, RCSI), Martin White (The Coombe Hospital and Department of Paediatrics and Child Health, RCSI), Marguerite Lawler (Children’s Health Ireland and Department of Paediatrics and Child Health, RCSI), Aideen Byrne (Children’s Health Ireland), John Fitzsimons (Children’s Health Ireland), Orla McNerney (Children’s Health Ireland).

    • Contributors SB co-designed the developmental aspect of the CORAL Study, collected data, analysed data and wrote the paper ( HS collated data, assisted in analysis and edited the paper. RF recruited participants, collected data and edited the paper. FB provided statistical input and edited the paper. DMM is the PI of the BASELINE Study. She provided input on CORAL developmental study design, data interpretation and edited the paper. JH is PI of the CORAL Study. He conceived and designed the CORAL Study and the developmental substudy, made the original clinical observation regarding social skills in infants, recruited participants, collected data, made data interpretation and wrote the paper. He is the guarantor of the work.

    • Funding This work was supported by the Temple Street Hospital Foundation in Dublin, Ireland (no grant number available) and the Clemens Von Pirquet Foundation in Geneva, Switzerland (no grant number available).

    • Competing interests JH is a board member of Clemens Von Pirquet Foundation. No other conflicts declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.