# Maternal COVID-19 in pregnancy not linked to ADHD or autism in 108,148 Japanese children

- Published: 2026-11-12 08:30 UTC
- Section: Life & Health › Medicine
- Tags: maternal COVID-19, COVID-19 during pregnancy, neurodevelopmental disorders, ADHD risk, autism spectrum disorder, intellectual disability, birth cohort study, propensity score matching, Japan claims database
- URL: https://realtech.media/news/rt-358f0291b1fb27730df5b6a5_maternal_covid_19/

**In a Japanese claims-database cohort, children of mothers with COVID-19 in pregnancy showed no higher rate of ADHD, autism or intellectual disability diagnoses over the available follow-up.**

![Maternal COVID-19 in pregnancy not linked to ADHD or autism in 108,148 Japanese children](https://realtech.media/media/2026/11/8b9726bb3c8137df.webp)
*ovid.com*

Yusuke Okubo and Kazuhiro Uda examined whether COVID-19 in a mother during pregnancy is associated with neurodevelopmental diagnoses in her child. According to the study abstract on ovid.com, it is a nationwide birth cohort of 108,148 singleton children in Japan, contributing 224,965 person-years of follow-up in an administrative claims database for 2020 to 2024. Maternal COVID-19 during pregnancy was recorded for 7797 children (7.2%) [1]. The work was published in The Pediatric Infectious Disease Journal.

## Design and cohort

The outcomes were clinically diagnosed attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), intellectual disability (ID) and a composite of the three. Diagnoses were identified from diagnostic codes and relevant prescription records. The primary analysis used Cox proportional hazards models with time-dependent propensity score matching [1].

Matching produced 7679 pairs of exposed and unexposed children, contributing 22,360 person-years, with well-balanced covariates. Hospitalization for COVID-19 was documented in 939 of the 7797 exposed pregnancies (12.0%). Before matching, mothers with COVID-19 had higher rates of infection, fever and asthma during pregnancy; mean maternal age was 32.7 years in the exposed group and 32.5 years in the unexposed group.

## Results and limitations

In the matched analysis, maternal COVID-19 was not associated with the composite outcome (hazard ratio [HR] 0.96; 95% confidence interval [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 ID (HR 1.06; 95% CI 0.55–2.01) [1]. For the composite outcome, no association was found for infection in the first (HR 1.00; 95% CI 0.20–4.96), second (HR 1.00; 95% CI 0.40–2.52) or third trimester (HR 0.93; 95% CI 0.44–1.98).

Multivariable-adjusted models gave similar results, with an HR of 0.89 (95% CI 0.61–1.29) for the composite outcome. A sibling comparison of 2278 children also showed no association (composite HR 0.86; 95% CI 0.26–2.82). A sensitivity analysis with stricter diagnostic criteria gave a composite HR of 0.73 (95% CI 0.29–1.81) [1].

The authors report no evidence of increased risk during the available follow-up. They list residual confounding, possible misclassification of exposure or outcome in claims-based diagnoses, and exclusion of pregnancy losses as limitations. The database mainly covers employees of medium- and large-sized companies and their dependents, which may limit generalizability. The authors note that longer follow-up remains important, because some neurodevelopmental conditions may become evident later in childhood.

## Sources

1. [ovid.com](https://www.ovid.com/jnls/pidj/abstract/10.1097/inf.0000000000005436~maternal-covid-19-during-pregnancy-and-offspring?redirectionsource=fulltextview)
2. [thecardiologyadvisor.com](https://www.infectiousdiseaseadvisor.com/news/maternal-covid19-pregnancy-offspring-neurodevelopmental-disorders)

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Source: RealTech, realtech.media — https://realtech.media/news/rt-358f0291b1fb27730df5b6a5_maternal_covid_19/