Pediatrics · Obstetrics & Gynecology · 4 h ago
Prenatal mRNA COVID-19 vaccination not linked to neurodevelopmental differences at 18–30 months
In a multicenter prospective cohort, researchers compared neurodevelopmental measures in 434 children whose mothers received an mRNA COVID-19 vaccine during or shortly before pregnancy with measures in children whose mothers did not. At a median age of 25.8 months, the groups had equivalent ASQ-3 scores, with no significant differences in secondary measures.
- ASQ-3 scores met the study’s prespecified equivalence criterion.
- No significant differences emerged in secondary developmental measures.
- Follow-up covered children aged 18 to 30 months.
- The observational study cannot establish causation.
This multicenter prospective cohort study enrolled children aged 18 to 30 months at 14 centers in the NICHD Maternal-Fetal Medicine Units Network during 2024–2025. Maternal mRNA SARS-CoV-2 vaccination during pregnancy or within 30 days before pregnancy defined exposure. Researchers enrolled 271 exposed and 240 unexposed children; matching on delivery site, date, insurance status, and race and ethnicity was possible for 217 pairs. The primary outcome was the Ages and Stages Questionnaire, third edition (ASQ-3), total score. Secondary measures included domain-specific ASQ-3 scores and several behavioral and autism-screening questionnaires.
Among the 434 children enrolled, median age at assessment was 25.8 months. The primary outcome met the study’s criterion for equivalence: median ASQ-3 scores were 255 in the exposed group and 260 in the unexposed group, with an adjusted median difference of −3.4 (90% CI, −9.8 to 3.0). No significant differences were reported in secondary outcomes.
The findings provide evidence against measurable differences in these developmental assessments through 30 months after prenatal or immediately pre-pregnancy mRNA vaccination. The observational design cannot establish causation, and follow-up was limited to early childhood; the study does not address later developmental outcomes. The authors said the findings support continued recommendations for vaccination during pregnancy.
In practice
For pregnant people considering mRNA SARS-CoV-2 vaccination, this prospective cohort found equivalent ASQ-3 scores at 18 to 30 months among children exposed during or within 30 days before pregnancy compared with unexposed children; secondary developmental and behavioral measures also did not differ significantly. These findings are reassuring for measured early-childhood outcomes, but they do not establish causality or resolve outcomes beyond 30 months. The study supports existing recommendations, but by itself does not warrant a change in clinical practice.
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JAMA Pediatrics: SARS-CoV-2 mRNA Vaccination in Pregnancy and Child Neurodevelopment at 18 to 30 Months ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.