Other maternal infections during pregnancy have been linked with risk for a range of neurodevelopmental diseases during childhood, and animal studies have shown that immune activation during pregnancy disrupts normal fetal brain development and offspring behavior. To assess the effects of SARS-CoV-2 infection during pregnancy, investigators analyzed data on 18,124 live births at Mass General Brigham within the peak COVID-19 window of March 2020 to May 2021.
The investigators studied 18,124 mother-child pairs. Among the 861 children whose mothers were SARS-CoV-2–positive during pregnancy, 140 (16.3%) received a neurodevelopmental diagnosis by 3 years of age, compared with 1,680 (9.7%) of the 17,263 remaining children from SARS-CoV-2–negative pregnancies. After adjusting for other influencing factors, SARS-CoV-2 infection during pregnancy was associated with 29% higher odds of a neurodevelopmental condition in children.
The investigators also found that males were at higher risk than females. Risk was greatest when infection occurred during the third trimester of pregnancy.
While reducing risk is important, co-senior author Roy Perlis, MD, MSc, of the Mass General Brigham Department of Psychiatry, noted, “The overall risk of adverse neurodevelopmental outcomes in exposed children likely remains low.”
First author and Maternal-Fetal Medicine specialist Lydia Shook, MD, added, “Parental awareness of the potential for adverse child neurodevelopmental outcomes after COVID-19 in pregnancy is key. By understanding the risks, parents can appropriately advocate for their children to have proper evaluation and support.”
Reference:
Shook, Lydia L. MD; Castro, Victor MS; Ibanez-Pintor, Laura MD; Perlis, Roy H. MD, MSc; Edlow, Andrea G. MD, MSc. Neurodevelopmental Outcomes of 3-Year-Old Children Exposed to Maternal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Utero. Obstetrics & Gynecology ():10.1097/AOG.0000000000006112, October 30, 2025. | DOI: 10.1097/AOG.0000000000006112.
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