PRENATAL COVID-19 exposure has not been linked to a broad increase in neurodevelopmental disorders in a large Norwegian cohort study, though a sensitivity analysis restricted to the early pandemic identified a heightened risk of speech or language disorders.
This cohort study included all children born in Norway between March 2020 and December 2023, with at least 22 completed gestational weeks and a birth weight above 500g. Data were drawn from national registries covering maternal background, birth characteristics, prenatal COVID-19 exposure, and neurodevelopmental and neurological diagnoses. Maternal COVID-19 was defined as a positive PCR result for SARS-CoV-2 between conception and delivery.
Eight outcomes were assessed, including any neurodevelopmental disorder, autism, developmental speech or language disorders, motor disorders, intellectual disorders, any neurological disorder, epilepsy, and sensory impairments, using Cox proportional hazards regression.
Among 204,663 children (51.2% male), 16,325 (8.0%) were exposed to maternal COVID-19 in pregnancy. Exposed children showed no increased risk of any neurodevelopmental disorder (adjusted HR 0.97, 95% CI 0.88 to 1.08), autism (AHR 0.88, 95% CI 0.67 to 1.15), speech or language disorders (AHR 1.13, 95% CI 0.80 to 1.59), motor disorders (AHR 0.83, 95% CI 0.44 to 1.56), intellectual disorders (AHR 1.19, 95% CI 0.65 to 2.19), any neurological disorder (AHR 0.97, 95% CI 0.88 to 1.07), epilepsy (AHR 1.14, 95% CI 0.87 to 1.48), or sensory impairments (AHR 1.09, 95% CI 0.92 to 1.30).
However, a sensitivity analysis excluding children born after March 2022, designed to limit misclassification from reduced testing availability, found an increased risk of speech or language disorders among exposed children (AHR 2.22, 95% CI 1.44 to 3.41).
These findings have provided broad reassurance that prenatal COVID-19 exposure is not associated with increased neurodevelopmental or neurological disorder risk, aside from a signal for speech or language disorders in early pandemic-exposed children. As this stems from a single sensitivity analysis, replication in other populations is needed before it informs clinical monitoring.
Magnus MC et al. Prenatal COVID-19 exposure and neurodevelopmental and neurological disorders in children. JAMA Netw Open. 2026;9(9):e2631847.
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