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COVID-19 infection during pregnancy and infant neurodevelopment

Pediatric Research (2025)Cite this article

Abstract

Introduction

The impact of maternal SARS-CoV-2 infection on fetal brain development during pregnancy remains unclear. Prior research has associated other antenatal infections with adverse neurodevelopmental outcomes in offspring.

Objective

To compare neurodevelopmental outcomes in infants born to mothers infected with SARS-CoV-2 during pregnancy (COVID+) to infants without congenital exposure (COVID−).

Methods

This study included 77 COVID+ infants and 157 COVID- infants assessed at 6 and/or 12 months. Outcomes were based on maternal self-report, observed infant behavior and brain fMRI.

Results

Overall, COVID+ and COVID− infant groups showed no significant differences across a range of neurobehavioral measures. However, analyses not adjusted for multiple comparisons revealed differences: fewer night awakenings at 6 (t(154) = 2.24, p < 0.03) and 12 months (t(107) = 1.94, p < 0.05), and reduced duration of orienting at 12 months (t(55.38) = 2.15, p < 0.04) in COVID+ infants. Neural differences were noted in posterior-anterior midline, insular-frontal, insular-posterior cingulate, and frontal-cingulate regions at an uncorrected threshold of p < 0.01.

Conclusion

This study of multi-level infant development suggests that infants born to mothers infected with COVID during pregnancy are not experiencing harmful effects of that exposure.

Impact

  • This study contributes comprehensive data on infant neurodevelopmental outcomes following prenatal SARS-CoV-2 exposure, evaluating a wide range of behavioral and neural measures to address gaps in previous research.

  • Findings suggest that congenital exposure to SARS-CoV-2 does not result in significant neurodevelopmental impairments in infants, offering reassurance amidst concerns about potential long-term effects of maternal prenatal COVID-19 infection.

  • Results indicate that any observed differences, such as fewer night awakenings and functional neural connectivity patterns, may reflect a more mature developmental profile in the exposed group.

  • Continued longitudinal research is necessary to understand behaviorally relevant and lasting neurodevelopmental effects of prenatal SARS-CoV-2 exposure.

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Fig. 1: Box plots depicting paired comparison of COVID+ and COVID- groups across observed infant behaviors using Welch’s t-tests.
Fig. 2: Estimated effect size for self-report and observed behavioral dimensions.
Fig. 3: Box plots depicting paired comparison of COVID+ and COVID- groups across maternal self-report measures of infant behavior using Welch’s t-tests.
Fig. 4: Examination of congenital SARS-CoV-2 exposure-related variation in infant brain functional connectivity.
Fig. 5: Examination of age-related variation in infant brain functional connectivity.

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Data availability

The investigators contributing to this manuscript are committed to the principles of open and reproducible science. Data from our fetal and infant neuroimaging studies are available on OpenNeuro and on the NIMH NDAR Data Archive. Any additional queries can be directed to the corresponding author.

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Acknowledgements

The authors thank Maggie Zhang, Harini Srinivasan, Amyn Majbri, Amy Hume, Leslie Gaines for contributions to data collection and data management. Importantly, the authors also thank participant families who generously shared their time and expressed interest in helping future babies to achieve their best possible health outcomes. Funding. This project was supported by awards from the National Institutes of Health, MH122447, MH125870, MH126468, DA055338, and ES032294, and by NARSAD Young Investigator Grants from the Brain and Behavior Foundation (to DMW and CM).

Author information

Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, New York University Medical Center, New York, NY, USA

    Moriah E. Thomason, Lanxin Ji, Iris Menu, Cassandra L. Hendrix, Bradley Susskind, Mark Duffy & Clare McCormack

  2. Department of Population Health, New York University Medical Center, New York, NY, USA

    Moriah E. Thomason

  3. Neuroscience Institute, New York University Medical Center, New York, NY, USA

    Moriah E. Thomason

  4. Department of Psychology, University of California, Irvine, Irvine, CA, USA

    Denise M. Werchan

  5. Department of Psychology, Columbia University, New York, NY, USA

    Natalie H. Brito

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Contributions

MET and NHB designed the study and contributed materials. DW, CH, LJ, IM, BS, and MD analyzed the data. MET, DW, LJ, NHB and CM conceptualized and wrote the paper.

Corresponding author

Correspondence to Moriah E. Thomason.

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Competing interests

The authors report no biomedical financial interests or potential conflicts of interest.

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The research protocol for this study was approved by the NYU Langone Institutional Review Board (IRB). Only patients who had previously consented to be contacted about research opportunities were eligible for invitation into the study. Participants provided consent to share de-identified data. The approved study protocol included the sharing of de-identified data with outside researchers or research databases.

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Thomason, M.E., Werchan, D.M., Ji, L. et al. COVID-19 infection during pregnancy and infant neurodevelopment. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04409-y

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