Key Points:
- Exposed children had a 29% higher risk of autism, speech delays, and motor disorders.
- Male children and third-trimester exposure faced the highest risk.
- Early screening and monitoring can help detect developmental issues.
A new study by researchers at Mass General Brigham, published on Oct. 30, 2025, indicates that COVID-19 pregnancy risk may increase the likelihood of neurodevelopmental disorders in children by age three. The study, appearing in Obstetrics & Gynecology, suggests that exposure to the virus in utero could subtly alter fetal brain development.
The research analyzed 18,124 live births from March 2020 to May 2021, comparing developmental outcomes in children born to mothers who tested positive for SARS-CoV-2 during pregnancy with those who did not. Among 861 exposed children, 16.3% were diagnosed with a neurodevelopmental condition by age three. In contrast, 9.7% of 17,263 unexposed children received similar diagnoses. After adjusting for other factors, maternal COVID-19 infection was linked to a 29% higher likelihood of developmental conditions such as speech delays, autism, and motor disorders.
COVID-19 may affect the fetal brain
“These findings highlight that COVID-19, like other infections in pregnancy, may pose risks not only to the mother but also to fetal brain development,” said Dr. Andrea Edlow, senior author and Maternal-Fetal Medicine specialist at Mass General Brigham. She emphasized the importance of infection prevention during pregnancy, particularly as public confidence in vaccines continues to waver.
Researchers observed that male offspring faced a greater risk of neurodevelopmental disorders than females. The risk was also highest when maternal infection occurred in the third trimester, suggesting that late-pregnancy exposure may have a stronger neurological impact, further underlining COVID-19 pregnancy risk.
Previous studies show similar patterns
The study builds on existing research linking maternal infections during pregnancy with increased risks of childhood neurodevelopmental disorders. Animal studies have shown that immune activation during pregnancy can disrupt normal brain development, leading to behavioral changes in offspring.
Co-senior author Dr. Roy Perlis, from the Department of Psychiatry at Mass General Brigham, noted that while the odds of developmental disorders were higher among children exposed to COVID-19 in utero, the overall risk remains relatively low. “Most children born after maternal infection will not experience developmental difficulties,” he said.
Awareness and early evaluation
Dr. Lydia Shook, the study’s first author and a Maternal-Fetal Medicine specialist, stressed the importance of early awareness and evaluation. “By understanding the risks, parents can advocate for early developmental screening and support for their children,” she said.
The findings underscore the need for continued monitoring of children born during the pandemic, as well as the importance of maintaining public health measures that protect pregnant women from infectious diseases.
Study details and disclosures
The study, titled “Neurodevelopmental Outcomes of 3-Year-Old Children Exposed to Maternal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Utero,” was conducted by Lydia L. Shook, Victor Castro, Laura Ibanez-Pintor, Roy H. Perlis, and Andrea Edlow.
Perlis serves on advisory boards for Alkermes, Circular Genomics, and Genomind, and holds equity in Circular Genomics. He is also a paid editor for JAMA and JAMA Network Open. Edlow serves on the scientific advisory board for YourBio Health and consults for Mirvie, Inc. and Merck & Co., Inc., with research funding from Merck unrelated to this study. The authors reported no additional conflicts of interest.
The researchers plan to continue tracking developmental outcomes as the children grow older to better understand the long-term impacts of COVID-19 pregnancy risk on child health.
