A new study suggests that children whose mothers had COVID-19 during pregnancy face a 29% higher risk of developing neurodevelopmental conditions, including speech delays, motor disorders, and autism by age three. Experts note that the overall odds are still low and may have decreased since the pandemic’s peak.
Researchers at Massachusetts General Hospital analyzed data from 18,124 live births at Mass General Brigham between March 2020 and May 2021. Previous studies have linked maternal infections to increased risk of childhood neurodevelopmental disorders. Animal studies indicate that activation of the immune system during pregnancy can disrupt fetal brain development. The study was published in Obstetrics & Gynecology.
Boys Show Higher Risk, Third Trimester Most Critical
Among pregnant women, 8% of those uninfected had at least one COVID-19 vaccine dose, compared with 2% of infected women. Only 13 infections occurred in vaccinated women, and 65% of all infections happened in the third trimester.
Of the 861 children exposed to COVID-19 in utero, 16.3% were diagnosed with at least one neurodevelopmental condition by age three, compared with 9.7% of the 17,263 children whose mothers were COVID-negative. After adjusting for maternal age, race, insurance, hospital type, and preterm birth, prenatal COVID-19 infection was linked to a 29% higher risk of such disorders.
Senior author Andrea Edlow, MD, said, “These findings highlight that COVID-19, like many other infections in pregnancy, may pose risks not only to the mother but also to fetal brain development.” Boys faced a 43% higher risk than girls, with the greatest risk (36%) when exposure occurred in the third trimester. Other risk factors included Hispanic ethnicity, public insurance, preterm birth, and delivery in an academic medical center rather than a community hospital.
Common Diagnoses Include Speech, Motor, and Psychological Disorders
The most frequent conditions were speech and language disorders, developmental motor-function disorder, autism, and other psychological development disorders. COVID-19 during pregnancy was also associated with higher rates of preterm delivery (13.5% vs 10%) and slightly lower birth weights.
Lead author Lydia Shook, MD, emphasized, “Parents should be aware of potential adverse neurodevelopmental outcomes after COVID-19 infection during pregnancy. Understanding the risks allows them to advocate for proper evaluation and support for their children.”
Experts Suggest Risk May Have Decreased Over Time
Michael Osterholm, PhD, MPH, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, cautioned that these findings may not reflect current risks. He noted that other early COVID-related immune complications, like myocarditis and MIS-C, have sharply declined.
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