MRI study shows COVID-19 during pregnancy does not harm fetal brain development

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December 08, 2021

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COVID-19 appears to have no effect on the brains of the developing fetuses of pregnant women with mild to moderate cases of the disease, according to a study presented at the Radiological Society of North America Annual Meeting.

“Women infected with SARS-CoV-2 during pregnancy are concerned that the virus may affect the development of their unborn child, as is the case with some other viral infections,” author Sophia Stöcklein, MD, of the department of radiology at Ludwig Maximilian University of Munich, said in a press release.

“So far, although there are a few reports of vertical transmission to the fetus, the exact risk and impact remain largely unclear. The aim of our study was to fill this gap in knowledge regarding the impact of a maternal SARS-CoV-2 infection on fetal brain development,” she said.

The researchers used fetal MRI to study 33 patients with COVID-19 infection during pregnancy. The patients were at a mean of 28.4 weeks into their pregnancies (range, 18 to 39 weeks).

Symptom onset occurred at a mean of 18.3 weeks (range, 4 to 34 weeks) into the pregnancy. The most common maternal symptoms were reduced or lost sense of smell (n = 29; 87.9%), reduced or lost sense of taste (n = 26; 78.8%), dry cough (n = 19; 57.6%), fever (n = 9; 27.3%) and shortness of breath (n = 10; 30.3%). Patients were otherwise healthy.

A pair of board-certified radiologists with 3 and 4 years of experience respectively in fetal MRI evaluated the scans, including the brain’s surface, the brain’s fluid-filled spaces, potential signs of brain swelling and brain calcifications. They also quantified brain stem structures.

Based on the analysis, the brain development in the assessed areas was age-appropriate in all fetuses. There were no calcifications, signs of swelling or widening of the brain’s fluid-filled spaces, and no findings indicated fetal brain infection.

“In our study, there was no evidence that a maternal SARS-CoV-2 infection has any effect on the brain development of the unborn child,” said Stöcklein. “This fact should help to reassure affected patients.”

The study only included mothers with mild to moderate symptoms who were not hospitalized, Stöcklein said.

“Since the impact of severe infection on brain development in the fetus has not been conclusively determined, active protection against SARS-CoV-2 infection during pregnancy remains important,” she said.

The researchers noted that the CDC recommends that women who are pregnant or who are thinking about getting pregnant should get vaccinated against COVID-19 to reduce the risk for severe illness.

“So far, vaccination is the most promising protection against COVID-19,” Stöcklein said. “Any potential side effects are manageable, even in pregnant women. Therefore, despite the encouraging results of our study, pregnant women should strongly consider vaccination.”

The researchers said they will continue to recruit new patients and follow them for the next 5 years, including detailed neonatal assessment and assessment of neurological development.


  • Koliogiannis V, et al. SARS-CoV-2 infection during pregnancy: Does fetal MRI show signs of impaired fetal brain development? Presented at: Radiological Society of North America Annual Meeting; Nov. 28-Dec. 2, 2021; Chicago (hybrid meeting).

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