Pregnancy COVID-19 Not Linked to Offspring Neurodevelopmental Diagnoses During Available Follow-up

A nationwide birth cohort study in The Pediatric Infectious Disease Journal examined whether maternal COVID-19 during pregnancy was associated with offspring attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), intellectual disability or a composite of these outcomes. Researchers used administrative claims data from 2020–2024 covering 108,148 singleton children and 224,965 person-years. Primary analyses used Cox models with time-dependent propensity score matching.

Overall, 7,797 children (7.2%) were exposed to maternal COVID-19. Matching produced 7,679 pairs contributing 22,360 person-years, with well-balanced measured covariates. Maternal infection was not associated with the composite outcome (hazard ratio [HR], 0.96; 95% CI, 0.56–1.66), ADHD (HR, 0.75; 95% CI, 0.32–1.78), ASD (HR, 0.79; 95% CI, 0.40–1.55) or intellectual disability (HR, 1.06; 95% CI, 0.55–2.01).

Adjusted models, sibling comparisons, trimester-specific analyses and sensitivity analyses addressing outcome misclassification yielded similar null findings. These results provide some reassurance for pregnancy counseling, but do not establish the absence of risk. Confidence intervals encompass potentially meaningful increases, and conclusions apply only to diagnoses recorded during the available follow-up. The observational, claims-based design also limits causal interpretation.