COVID-19 during pregnancy may increase risk of autism and neurodevelopmental disorders

A new study from Mass General Brigham suggests that COVID-19 infection during pregnancy may subtly alter fetal brain development, increasing the risk of speech, motor and autism-related disorders in early childhood.

study: Neurodevelopmental outcomes in 3-year-old children exposed to maternal in utero severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.. Image credit: Dagmara_K/Shutterstock

Children born to mothers who contracted COVID-19 during pregnancy are at increased risk for developmental disabilities by age 3, including language delays, autism, motor difficulties and other neurodevelopmental delays, according to a new study from Mass General Brigham researchers. Research results are published in journals. obstetrics and gynecology.

COVID-19 may affect fetal brain development

“These findings highlight that COVID-19, like many other infections during pregnancy, may pose a risk not only to the mother but also to the brain development of the fetus,” said lead author Dr. Andrea Edlow, a maternal-fetal medicine specialist at Mass General Brigham. She emphasized the importance of preventing infection during pregnancy, especially as public trust in vaccines, including the COVID-19 vaccine, is eroding.

Previous research links maternal infections with childhood neurodevelopmental disorders

Other maternal infections during pregnancy are associated with an increased risk for a variety of neurodevelopmental disorders in childhood. Animal studies have demonstrated that immune activation during pregnancy can disrupt normal fetal brain development and offspring behavior.

Study design and population

To assess the impact of SARS-CoV-2 infection during pregnancy, investigators analyzed data on 18,124 live births at Mass General Brigham during the peak COVID-19 period (March 2020 to May 2021). The study looked at 18,124 mother-baby pairs to identify possible associations between maternal infections and child neurodevelopmental outcomes.

Increased neurodevelopmental risk after maternal SARS-CoV-2 infection

Of 861 children of mothers who tested positive for SARS-CoV-2 during pregnancy, 140 (16.3%) received a neurodevelopmental diagnosis by age 3. In comparison, 1,680 of 17,263 (9.7%) children born to SARS-CoV-2-negative mothers were diagnosed with these conditions. After accounting for confounding factors, maternal COVID-19 infection was associated with a 29% higher likelihood of developing neurodevelopmental disorders in children.

Higher risk observed in male offspring and late pregnancy infections

Researchers found that boys were more likely to develop neurodevelopmental disorders than girls. The risk was highest when maternal infection occurred in the third trimester of pregnancy, suggesting that exposure later in pregnancy may have greater neurological effects.

Despite the high odds, the overall risk is still low

While infection increased the likelihood of developmental disabilities, co-senior author Dr. Roy Perlis, a member of the Department of Psychiatry at Mass General Brigham, noted that “the overall risk for adverse neurodevelopmental outcomes in exposed children is likely still low.”

The Importance of Early Recognition and Parental Advocacy

Dr. Lydia Shook, first author and maternal-fetal medicine expert, emphasized that awareness is key. “By understanding the risks, parents can properly advocate for their children to receive appropriate evaluations and developmental supports,” she said.

Study authors and institutional affiliations

In addition to Dr. Edlow, Brigham Mass General co-authors include Lydia L. Shook, Victor Castro, Laura Ibanez-Pintor, and Roy H. Perlis.

Disclosures and Potential Conflicts of Interest

Perlis reports holding shares in Circular Genomics and serving on the advisory boards of Alkermes, Circular Genomics, and Genomind. He is a paid editor. Zama and JAMA Network Open. Edlow serves on the Scientific Advisory Board of YourBio Health and is a member of Mirvie, Inc. and Merck & Co., Inc. She also receives research funding from Merck, all of which is unrelated to her current work. The authors report no other conflicts of interest.