In Utero SARS‐CoV‐2 Exposure Linked to Higher Risk of Neurodevelopmental Disorders

Study found risk was higher only for male babies; larger studies and longer follow-up needed

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This article is part of Harvard Medical School’s continuing coverage of COVID-19.

At a glance

  • A study found that SARSCoV2 infection during pregnancy was linked to higher risk of neurodevelopmental disorders in male babies.
  • SARSCoV2 during pregnancy was not associated with increased risk of neurodevelopmental disorders in female babies.
  • Larger studies and longer follow-up are needed to confirm and understand this risk.

A new study has found that male but not female babies born to women who tested positive for SARSCoV2 during pregnancy were more likely to be diagnosed with a neurodevelopmental disorder in their first 12 months.

The research, led by investigators at Harvard Medical School and Massachusetts General Hospital, was published on March 23 in JAMA Network Open.

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Previous research has found associations between other infections during pregnancy and increased risk of neurodevelopmental disorders in children, including autism. However, it has been unclear if such a link exists for SARSCoV2.

To investigate this link, scientists examined electronic health records for 18,355 live births during the COVID-19 pandemic, including 883 babies (4.8 percent) born to women who tested positive for the coronavirus during pregnancy.

Of the 883 babies in the study who had been exposed to SARSCoV2, 26 (3 percent) were diagnosed with a neurodevelopmental disorder during their first 12 months. Only 317 babies (1.8 percent) not exposed to SARSCoV2 received such a diagnosis.

After accounting for race, age, ethnicity, insurance status, hospital type, and preterm status, the team found that male babies born to individuals who had a SARSCoV2 infection during pregnancy were almost twice as likely to be diagnosed with a neurodevelopmental disorder by 12 months than those born to women not infected with SARSCoV2. SARSCoV2 infection during pregnancy was not linked with higher risk of neurodevelopmental disorders in female children.

At 18 months, the effect was more modest in males: SARSCoV2 infection during pregnancy was linked to a 42 percent higher chance of a neurodevelopmental diagnosis at this age. Too few of the women were vaccinated to determine whether vaccination status affected risk.

“The neurodevelopmental risk associated with maternal SARS-CoV-2 infection was disproportionately high in male infants, consistent with the known increased vulnerability of males in the face of prenatal adverse exposures,” says co-lead author Andrea Edlow, HMS associate professor of obstetrics, gynecology, and reproductive biology at Mass General.