tetano
Editor, Senior Moderator
Obstet Gynecol
. 2025 Oct 30.
doi: 10.1097/AOG.0000000000006112. Online ahead of print. Neurodevelopmental Outcomes of 3-Year-Old Children Exposed to Maternal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Utero
Lydia L Shook[SUP] 1 [/SUP], Victor Castro, Laura Ibanez-Pintor, Roy H Perlis, Andrea G Edlow
Affiliations
Objective: To determine whether in utero exposure to maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with increased risk of adverse neurodevelopmental outcomes in children by age 3 years.
Methods: We conducted a retrospective cohort study of 18,124 live births to individuals who delivered between March 1, 2020, and May 31, 2021, within the Mass General Brigham health system. The exposure of interest was maternal SARS-CoV-2 infection, defined as a positive SARS-CoV-2 polymerase chain reaction test result during pregnancy. The outcome of interest was presence of any neurodevelopmental diagnosis up to 36 months after birth, identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnostic codes. To evaluate the association between SARS-CoV-2 exposure in pregnancy and these diagnoses, we used logistic regression models adjusting for maternal age, race and ethnicity, insurance type, hospital type, and preterm birth.
Results: Among the 861 individuals with SARS-CoV-2-exposed pregnancies (4.8%), 140 offspring (16.3%) received a neurodevelopmental diagnosis by 36 months after birth, compared with 1,680 of 17,263 unexposed offspring (9.7%) (unadjusted odds ratio 1.80, 95% CI, 1.49-2.17; adjusted odds ratio [aOR] 1.29, 95% CI, 1.05-1.57, P=.01). In sensitivity analyses, largest effects were observed in third-trimester exposures, overall (aOR 1.36, 95% CI, 1.07-1.72, P=.01), and among male offspring (aOR 1.43, 95% CI, 1.05-1.91, P=.02).
Conclusion: Maternal SARS-CoV-2 infection in pregnancy was associated with increased risk of adverse neurodevelopmental diagnoses by age 3 years, with effects most pronounced after third-trimester exposure and in male offspring. These findings highlight the importance of long-term neurodevelopmental monitoring for SARS-CoV-2-exposed children.
. 2025 Oct 30.
doi: 10.1097/AOG.0000000000006112. Online ahead of print. Neurodevelopmental Outcomes of 3-Year-Old Children Exposed to Maternal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Utero
Lydia L Shook[SUP] 1 [/SUP], Victor Castro, Laura Ibanez-Pintor, Roy H Perlis, Andrea G Edlow
Affiliations
- PMID: 41166717
- DOI: 10.1097/AOG.0000000000006112
Objective: To determine whether in utero exposure to maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with increased risk of adverse neurodevelopmental outcomes in children by age 3 years.
Methods: We conducted a retrospective cohort study of 18,124 live births to individuals who delivered between March 1, 2020, and May 31, 2021, within the Mass General Brigham health system. The exposure of interest was maternal SARS-CoV-2 infection, defined as a positive SARS-CoV-2 polymerase chain reaction test result during pregnancy. The outcome of interest was presence of any neurodevelopmental diagnosis up to 36 months after birth, identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnostic codes. To evaluate the association between SARS-CoV-2 exposure in pregnancy and these diagnoses, we used logistic regression models adjusting for maternal age, race and ethnicity, insurance type, hospital type, and preterm birth.
Results: Among the 861 individuals with SARS-CoV-2-exposed pregnancies (4.8%), 140 offspring (16.3%) received a neurodevelopmental diagnosis by 36 months after birth, compared with 1,680 of 17,263 unexposed offspring (9.7%) (unadjusted odds ratio 1.80, 95% CI, 1.49-2.17; adjusted odds ratio [aOR] 1.29, 95% CI, 1.05-1.57, P=.01). In sensitivity analyses, largest effects were observed in third-trimester exposures, overall (aOR 1.36, 95% CI, 1.07-1.72, P=.01), and among male offspring (aOR 1.43, 95% CI, 1.05-1.91, P=.02).
Conclusion: Maternal SARS-CoV-2 infection in pregnancy was associated with increased risk of adverse neurodevelopmental diagnoses by age 3 years, with effects most pronounced after third-trimester exposure and in male offspring. These findings highlight the importance of long-term neurodevelopmental monitoring for SARS-CoV-2-exposed children.