Risk Higher for Male Babies in Study, More Data Needed

Harvard Medical School

This article is part of Harvard Medical School's continuing coverage of COVID-19.

  • By TRACY HAMPTON | MGH News and Public Affairs

At a glance

  • A study found that SARS‐CoV‐2 infection during pregnancy was linked to higher risk of neurodevelopmental disorders in male babies
  • SARS‐CoV‐2 during pregnancy was not associated with increased risk of neurodevelopmental disorders in female babies
  • Larger studies and longer follow-up are needed to confirm and understand this risk

A new study has found that male but not female babies born to women who tested positive for SARS‐CoV‐2 during pregnancy were more likely to be diagnosed with a neurodevelopmental disorder in their first 12 months.

The research, led by investigators at Harvard Medical School and Massachusetts General Hospital, was published on March 23 in JAMA Network Open.

Previous research has found associations between other infections during pregnancy and increased risk of neurodevelopmental disorders in children, including autism. However, it has been unclear if such a link exists for SARS‐CoV‐2.

To investigate this link, scientists examined electronic health records for 18,355 live births during the COVID-19 pandemic, including 883 babies (4.8 percent) born to women who tested positive for the coronavirus during pregnancy.

Of the 883 babies in the study who had been exposed to SARS‐CoV‐2, 26 (3 percent) were diagnosed with a neurodevelopmental disorder during their first 12 months. Only 317 babies (1.8 percent) not exposed to SARS‐CoV‐2 received such a diagnosis.

After accounting for race, age, ethnicity, insurance status, hospital type, and preterm status, the team found that male babies born to individuals who had a SARS‐CoV‐2 infection during pregnancy were almost twice as likely to be diagnosed with a neurodevelopmental disorder by 12 months than those born to women not infected with SARS‐CoV‐2. SARS‐CoV‐2 infection during pregnancy was not linked with higher risk of neurodevelopmental disorders in female children.

At 18 months, the effect was more modest in males: SARS‐CoV‐2 infection during pregnancy was linked to a 42 percent higher chance of a neurodevelopmental diagnosis at this age. Too few of the women were vaccinated to determine whether vaccination status affected risk.

"The neurodevelopmental risk associated with maternal SARS-CoV-2 infection was disproportionately high in male infants, consistent with the known increased vulnerability of males in the face of prenatal adverse exposures," says co-lead author Andrea Edlow, HMS associate professor of obstetrics, gynecology, and reproductive biology at Mass General.

Larger studies and longer follow‐up will be required to reliably estimate or refute the risk observed, added co-lead author Roy Perlis, HMS professor of psychiatry and director of the Center for Quantitative Health at Mass General. "We hope to continue to expand this cohort and to follow them over time to provide better answers about any longer-term effects," he said.

Authorship, funding, disclosures

Additional authors on the paper include Victor Castro of Mass General and Mass General Brigham; Lydia Shook of Mass General and HMS; Sebastien Haneuse of Harvard T.H. Chan School of Public Health; and Anjali Kaimal of the University of South Florida College of Medicine, Tampa.

This research was supported by the National Institute of Mental Health (RF1MH132336; R01 MH116270; U54 MH118919); the National Institute of Child Health and Human Development (R01 HD100022-02S2; K12 HD103096-03); and the Simons Foundation Autism Research Initiative (870754).

Edlow is a consultant for Mirvie. Perlis has received personal fees from Genomind, Burrage Capital, Psy Therapeutics, Circular Genomics, and Vault Health.

Adapted from a Mass General news release.

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