What happens to children who were exposed to COVID-19 in the womb? A large new US study of over 18,000 births is giving us some of the first long-term answers.
The Numbers
The study, published through the NIH in 2025, followed children from birth to age three. Among children whose mothers had COVID-19 during pregnancy, 16.3 percent developed some form of neurological challenge by age three. This includes speech delays, motor challenges, and autism spectrum diagnoses.
By comparison, the figure was 9.7 percent among children whose mothers had not been infected. That is a noticeable difference, though the researchers emphasize that most children in both groups developed entirely normally.
What Might Explain This?
The researchers point to several possible mechanisms. Mothers who had COVID during pregnancy had a higher incidence of preterm birth and lower birth weight — both well-known risk factors for developmental delays.
It is important to note that the study primarily included unvaccinated mothers, as many of the births occurred before vaccines were available. The findings therefore speak mainly to the virus itself, not to the risk for vaccinated pregnant people.
The study is observational and cannot prove direct causation. Other factors — such as stress, isolation, and reduced access to healthcare during the pandemic — may also have played a role.
What This Means for You
The CDC and AAP recommend that pregnant people stay up to date with their COVID-19 vaccinations. Most pregnant people who contract COVID-19 experience a mild course of illness. If you have questions about vaccination during pregnancy or have specific risk factors, speak with your OB-GYN or midwife.
You can read more about staying healthy during pregnancy in our pregnancy health guide.
Frequently Asked Questions
Should I be concerned about COVID-19 during pregnancy?
The vast majority of pregnant people who contract COVID-19 experience a mild illness. The CDC and AAP recommend that pregnant people stay current with their COVID-19 vaccinations. Speak with your doctor if you are unsure about vaccination or have specific risk factors. The most important steps are good hand hygiene and staying informed about current recommendations.
Does this research also apply to vaccinated pregnant people?
The study primarily included unvaccinated mothers, as many of the births occurred before vaccines were available. The findings therefore speak mainly to the virus itself. For vaccinated pregnant people, the risk picture is likely different, but more research is needed. The CDC recommends vaccination for pregnant people in line with current guidelines.
Does this mean children exposed to COVID in the womb will have problems?
No. Most children in the study — including those who were exposed — developed entirely normally. The difference between the groups was statistically noticeable, but this does not mean every individual child is affected. The study is observational and cannot prove direct causation. Other factors such as stress and reduced healthcare access during the pandemic may also have played a role.
Are children being monitored for pandemic-related developmental effects?
Pediatric research programs in the US and internationally continue to follow children born during the pandemic. In routine pediatric care, the AAP recommends that all children receive developmental screening at ages 9, 18, and 24–30 months. Contact your pediatrician if you are concerned about your child's development.