Male infants born to mothers with Covid-19 during pregnancy are at significantly higher risk of being diagnosed with a neurodevelopmental disorder at one year of age, according to a study of nearly 20,000 infants published in the journal JAMA Network Open.1 No such risk was observed for female children. The study further noted that though preterm births were more common among the exposed infants, the elevated risk was independent of preterm delivery.

In this study, researchers examined the differences in effect of laboratory-confirmed maternal SARS-CoV-2 infection during pregnancy on neurodevelopmental outcomes in children up to 18 months after birth. They evaluated electronic health records for 18,355 live births that occurred during the Covid-19 pandemic between March 1 and December 31, 2019. Of these 883 (4.8%) children were born to mothers with Covid-19 during pregnancy. They were compared with infants born in the pre-pandemic times between January 1 and December 31, 2018. The maternal mean age was 33 years.

Out of the 883 children exposed in-utero to Covid, 26 (3%) were diagnosed with a neurodevelopmental disorder within one year of birth, whereas 317 infants (1.8%) born prior to the pandemic were diagnosed with neurodevelopmental disorder. Retrospective analysis of data showed that male infants born to Covid-positive mothers were nearly twice at risk of neurodevelopmental disorders at one year of age (adjusted OR 1.94) compared to female children (aOR 0.89). Although the effects were more modest at 18 months of age, nevertheless the risk was still 42% higher (aOR 1.42) vs female children. Since very few of the mothers had taken the vaccine, hence, the effect of vaccination on the risk could not be determined.

The authors advocate further studies with a larger study group and longer follow-up duration to validate their findings.

Reference

1. Edlow AG, et al. Sex-specific neurodevelopmental outcomes among offspring of mothers with SARS-CoV-2 infection during pregnancy. JAMA Netw Open. 2023 Mar 1;6(3):e234415. doi: 10.1001/jamanetworkopen.2023.4415.