The association of in utero SARS-CoV-2 exposure on neurodevelopmental outcomes at 12 and 22 months.

Authors

Ashraf Kharrat, Erin Gleeson, Vanessa Pippert, Shaheen Doctor, Douglas Campbell, Catherine Taylor, Simone Vaz, Taslim Dawood, Seungwoo Lee, Jyotsna Shah, Edmond Kelly, Prakesh S Shah

Published in

Journal of perinatology : official journal of the California Perinatal Association. Jul 24, 2026. Epub Jul 24, 2026.

Abstract

Although vertical transmission of SARS-CoV-2 from mother to fetus is rare, the neurodevelopmental impact of in utero SARS-CoV-2 exposure on infants needs further elucidation.
To investigate the neurodevelopmental outcomes at 12 and 22 corrected age among infants who had exposure to confirmed maternal SARS-CoV-2 infection during pregnancy.
We conducted a prospective cohort study of neonates born to women with SARS-CoV-2 infection in pregnancy, from March 2020 to December 2022 (COVID-19 waves 1-5). Infants were recruited from six (5 community and 1 tertiary) hospitals. Data were collected at birth and three subsequent time periods. A telephone call was made at one month to assess general health and wellness. A virtual neurodevelopmental assessment was conducted at 12 months using the Ages and Stages Questionnaire (ASQ) and the Communication and Symbolic Behavior Scales (CSBS). In-person neurodevelopmental assessment was conducted at 22 months using the Bayley Scales of Infant and Toddler Development-4th Edition (BSID-IV).
A total of 142 infants were recruited and included in the study. Of those, a one-month assessment was completed in 141 (99%), a 12-month assessment completed in 63 (44%), and a 22-month assessment completed in 44 (31%) infants. At one month, most infants had no medical concerns; 11 infants were re-admitted to the hospital within the first month of life, predominantly for hyperbilirubinemia. At 12 months, median ASQ and CSBS scores were above standardized cut-offs for development across all developmental domains. At 22 months, while the median standard cognitive, language, and motor scores were within the average classification (25-37th percentile), twenty-three (52%) infants presented with developmental impairment (score <85); 13 (30%) in motor, 17 (39%) in language, and 13 (30%) in cognitive domains. Nine (20%) infants were below cut-off for all three domains. Multivariable logistic modelling did not identify an independent relationship between trimester of SARS-CoV-2 acquisition or positive SARS-CoV-2 test at delivery and the presence of developmental delay on BSID-IV in any domain. No child had hearing impairment or blindness.
Developmental delay at 22 months may be identified among infants with in utero exposure to SARS-CoV-2, despite typical developmental progress at 12 months. These findings may be impacted by the loss to follow-up rate. Of those with developmental diversity, language delay was most common.

PMID:
42498798
Bibliographic data and abstract were imported from PubMed on 25 Jul 2026.

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