The long-term consequences of COVID-19 virus infection during pregnancy on the neurodevelopment of kids, however, are currently being investigated. Thus, by identifying changes in quantitative measures of newborn brain development and assessing developmental and behavioral outcomes at two years of age using a combination of parent-reported and clinician-assessed measures, this study sought to characterize the neurodevelopmental impact of in utero COVID-19 exposure.
In a longitudinal research of newborn brain development, researchers prospectively recruited mother-baby dyads exposed to the SARS-CoV-2 virus during pregnancy (2020–2022) during the COVID-19 pandemic and compared them to a low-risk normative pre-pandemic group (2016–2019). At a newborn visit, when the baby was about two weeks of corrected age, quantitative 3-D volumetric magnetic resonance imaging (qMRI) was performed.
When the kid was about 2 years old, behavioral development was evaluated using the Infant-Toddler Social and Emotional Assessment (ITSEA) and the Bayley Scales of Infant and Toddler Developmental, Third Edition (BSID-III). The effects of SARS-CoV-2 exposure during pregnancy on the developmental outcomes of newborns and toddlers were evaluated using mediation analyses. Maternal age and educational attainment, newborn sex, and total brain volume on qMRI were taken into account in the analyses.
A total of 142 mother-child pairs with 103 from a normative prepandemic cohort and 39 pairs who had been exposed to the SARS-CoV-2 virus during pregnancy were prospectively recruited for this investigation. Changes in neonatal regional brain volumes in the cortical gray matter (q = 0.001), subcortical gray matter (q < 0.001), cerebral white matter (q = 0.005), and left hippocampus (q = 0.008) were linked to in utero virus exposure.
Additionally, viral exposure was linked to higher scores on the internalizing domain (q = 0.040) of the ITSEA and worse cognitive (q = 0.010) and social emotional (q = 0.001) scores on the BSID-III. The changed cortical gray matter volumes were partially responsible for the worse cognitive ratings on the BSID-III after SARS-CoV-2 exposure (21.9% mediated, p = 0.034).
The association between the SARS-CoV-2 virus exposure and higher internalizing behavior scores on the ITSEA was further mediated by these poorer cognition scores (61.0% mediated, p = 0.040). Overall, cortical gray matter sizes in the newborn brain moderated the relationship between in utero SARS-CoV-2 virus infection and reduced cognitive abilities in toddlers at age 2.
Source:
Weiner, S., Wu, Y., Cheng, J. J., Liggett, M., McCants, C., Adegbulugbe, E., Mears, A., Henderson, D., Andescavage, N., & Limperopoulos, C. (2026). The COVID generation: the neurodevelopmental consequences of in-utero COVID-19 exposure. Brain, Behavior, and Immunity, 106238, 106238. https://doi.org/10.1016/j.bbi.2025.106238
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