Prenatal exposure to SARS-CoV-2, early relational health, and child socio-emotional functioning in the first 6 months

Prenatal exposure to SARS-CoV-2, early relational health, and child socio-emotional functioning in the first 6 months | medRxiv Skip to main content Home About Submit ALERTS / RSS Search for this keyword Advanced Search Prenatal exposure to SARS-CoV-2, early relational health, and child socio-emotional functioning in the first 6 months View ORCID Profile Andréane Lavallée , View ORCID Profile Jennifer M. Warmingham , Jill B. Owen , Ruiyang L. Xu , Imaal Ahmed , Ginger D. Atwood , Margaret H Kyle , Maha Hussain , Vitoria Chaves , Elena Arduin , Marissa R. Lanoff , Sabrina P. Hyman , Lerzan Z. Coskun , Nicole Shearman , Jenna E. Russo , Sharon Ettinger , Esther A. Greeman , Danielle E. Serota , Mary L. Bence , Violet Hott , Yunzhe Hu , Georgia Kurman , Mayerly Lara , Helen Tzul Lopez , Isabelle Mollicone , Rupa Ravi , Cynthia Rodriguez , Grace C. Smotrich , Aoife Lawless , Perla Ontiveros-Ángel , Austen Curtin , Judy Austin , Morgan R. Firestein , Lauren C. Shuffrey , Cristina R. Fernández , Ashley N. Battarbee , Ann Bruno , Fatimah S. Dawood , Panagiotis Maniatis , Tyler C. Morrill , Gabriella Newes-Adeyi , Lawrence Reichle , Vera Semenova , Alan T. Tita , Michael Varner , View ORCID Profile Kristina Wielgosz , Rachel Marsh , Paul Curtin , View ORCID Profile Melissa S. Stockwell , Catherine Monk , Dani Dumitriu doi: https://doi.org/10.64898/2026.03.12.26346895 Andréane Lavallée 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York PhD Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Andréane Lavallée Jennifer M. Warmingham 2 Mt. Hope Family Center University of Rochester , Rochester, New York PhD Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Jennifer M. Warmingham Jill B. Owen 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York MPAcc Find this author on Google Scholar Find this author on PubMed Search for this author on this site Ruiyang L. Xu 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York MPH Find this author on Google Scholar Find this author on PubMed Search for this author on this site Imaal Ahmed 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York BS Find this author on Google Scholar Find this author on PubMed Search for this author on this site Ginger D. Atwood 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York BA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Margaret H Kyle 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York BA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Maha Hussain 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York MS Find this author on Google Scholar Find this author on PubMed Search for this author on this site Vitoria Chaves 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York MS Find this author on Google Scholar Find this author on PubMed Search for this author on this site Elena Arduin 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York MPH Find this author on Google Scholar Find this author on PubMed Search for this author on this site Marissa R. Lanoff 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York MA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Sabrina P. Hyman 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York MS Find this author on Google Scholar Find this author on PubMed Search for this author on this site Lerzan Z. Coskun 3 Department of Population Health, NYU Grossman School of Medicine , New York, New York PhD Find this author on Google Scholar Find this author on PubMed Search for this author on this site Nicole Shearman 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York BA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Jenna E. Russo 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York PhD Find this author on Google Scholar Find this author on PubMed Search for this author on this site Sharon Ettinger 4 Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, New York MA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Esther A. Greeman 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York MS Find this author on Google Scholar Find this author on PubMed Search for this author on this site Danielle E. Serota 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York BA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Mary L. Bence 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York BA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Violet Hott 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York BA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Yunzhe Hu 5 Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, New York BA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Georgia Kurman 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York BA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Mayerly Lara 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York BA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Helen Tzul Lopez 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York BA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Isabelle Mollicone 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York BA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Rupa Ravi 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York 6 Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center , New York, New York MPH Find this author on Google Scholar Find this author on PubMed Search for this author on this site Cynthia Rodriguez 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York BA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Grace C. Smotrich 5 Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, New York BA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Aoife Lawless 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York BS Find this author on Google Scholar Find this author on PubMed Search for this author on this site Perla Ontiveros-Ángel 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York PhD Find this author on Google Scholar Find this author on PubMed Search for this author on this site Austen Curtin 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York MA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Judy Austin 6 Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center , New York, New York PhD Find this author on Google Scholar Find this author on PubMed Search for this author on this site Morgan R. Firestein 7 Department of Pediatrics, Rutgers Robert Wood Johnson Medical School , New Brunswick, New Jersey 8 Child Health Institute of New Jersey, Rutgers Robert Wood Johnson Medical School , New Brunswick, New Jersey PhD Find this author on Google Scholar Find this author on PubMed Search for this author on this site Lauren C. Shuffrey 9 Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine , New York, New York PhD Find this author on Google Scholar Find this author on PubMed Search for this author on this site Cristina R. Fernández 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York 10 Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, New York MD, MPH Find this author on Google Scholar Find this author on PubMed Search for this author on this site Ashley N. Battarbee 11 Department of Obstetrics and Gynecology, University of Alabama at Birmingham , Birmingham, Alabama MD, MSCR Find this author on Google Scholar Find this author on PubMed Search for this author on this site Ann Bruno 12 Department of Obstetrics and Gynecology, University of Utah Health Sciences Center , Salt Lake City, Utah MD Find this author on Google Scholar Find this author on PubMed Search for this author on this site Fatimah S. Dawood 13 COVID-19 Response, Centers for Disease Control and Prevention , Atlanta, Georgia MD, MS Find this author on Google Scholar Find this author on PubMed Search for this author on this site Panagiotis Maniatis 13 COVID-19 Response, Centers for Disease Control and Prevention , Atlanta, Georgia MS Find this author on Google Scholar Find this author on PubMed Search for this author on this site Tyler C. Morrill 14 Abt Global , Rockville, Maryland MS Find this author on Google Scholar Find this author on PubMed Search for this author on this site Gabriella Newes-Adeyi 14 Abt Global , Rockville, Maryland PhD, MPH Find this author on Google Scholar Find this author on PubMed Search for this author on this site Lawrence Reichle 14 Abt Global , Rockville, Maryland MPH Find this author on Google Scholar Find this author on PubMed Search for this author on this site Vera Semenova 13 COVID-19 Response, Centers for Disease Control and Prevention , Atlanta, Georgia PhD Find this author on Google Scholar Find this author on PubMed Search for this author on this site Alan T. Tita 11 Department of Obstetrics and Gynecology, University of Alabama at Birmingham , Birmingham, Alabama MD Find this author on Google Scholar Find this author on PubMed Search for this author on this site Michael Varner 12 Department of Obstetrics and Gynecology, University of Utah Health Sciences Center , Salt Lake City, Utah MD Find this author on Google Scholar Find this author on PubMed Search for this author on this site Kristina Wielgosz 13 COVID-19 Response, Centers for Disease Control and Prevention , Atlanta, Georgia MPH Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Kristina Wielgosz Rachel Marsh 5 Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, New York 15 New York State Psychiatric Institute , New York, New York PhD Find this author on Google Scholar Find this author on PubMed Search for this author on this site Paul Curtin 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York PhD Find this author on Google Scholar Find this author on PubMed Search for this author on this site Melissa S. Stockwell 6 Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center , New York, New York 10 Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, New York 16 NewYork-Presbyterian Hospital , New York, New York MD, MPH Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Melissa S. Stockwell Catherine Monk 4 Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, New York 5 Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, New York PhD Find this author on Google Scholar Find this author on PubMed Search for this author on this site Dani Dumitriu 1 Center for Early Relational Health, Columbia University Irving Medical Center , New York, New York 5 Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, New York 10 Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, New York 15 New York State Psychiatric Institute , New York, New York 16 NewYork-Presbyterian Hospital , New York, New York MD, PhD Find this author on Google Scholar Find this author on PubMed Search for this author on this site For correspondence: dani.dumitriu{at}columbia.edu Abstract Full Text Info/History Metrics Supplementary material Data/Code Preview PDF Abstract Importance Parent/caregiver-infant early relational health (ERH) is known to play a critical role in the promotion of socio-emotional functioning and wellbeing across the life course. The negative impact of the COVID-19 pandemic on maternal mental health and secondarily on ERH and child socio-emotional functioning is clear. However, the direct impact of maternal viral exposure during pregnancy on ERH has not been investigated. Objective The goal of this study was to determine the impact of prenatal SARS-CoV-2 exposure on ERH and infant socio-emotional functioning in the first 6 months of life. Design Mothers with and without SARS-CoV-2 exposure during pregnancy who gave birth from 02/2020 to 09/2021 were enrolled from 05/2020 to 09/2021 in one of two parallel prospective studies (the COVID-19 Mother Baby Outcomes [COMBO] Initiative or the Respiratory Syndrome Coronavirus 2 in Pregnancy and Infancy [ESPI] COMBO sub-study). Mothers reported on their health and the socioemotional functioning of their infant via online surveys (REDCap) at enrollment, 1, 2, 4, and 6 months. At 4 to 6 months, dyads were invited to participate in a video-based, remote assessment of ERH. Participants 884 mother-infant dyads from three U.S. States (Alabama, New York, and Utah). Exposure Prenatal SARS-CoV-2. Main Outcomes and Measures Maternal-reported ERH (parental stress, parenting confidence and bonding) and observer-based ERH (video-coded quality of maternal caregiving behaviors and mother-infant emotional connection). Infant socio-emotional development assessed using the 6-month Ages and Stages Questionnaire: Socio-Emotional 2 nd Edition (ASQ:SE-2). Results 316 (36%) mothers had a positive prenatal SARS-CoV-2 exposure. Prenatal SARS-CoV-2 exposure was associated with an adjusted estimate of ∼5% reduction (incidence rate ratio=0.95, 95% confidence interval [0.90, 1.00], p=0.03) in observed maternal caregiving quality, after accounting for postnatal maternal mental health and sociodemographic factors. We found no evidence of effect on other ERH constructs or infant socio-emotional functioning. Conclusions and Relevance In this large prospective cohort study, prenatal SARS-CoV-2 was associated with a small decrement in caregiving quality, but not other ERH constructs or infant socioemotional functioning. These findings should be interpreted as hypothesis generating and will require replication in independent studies. Key Points Question : Is SARS-CoV-2 exposure during pregnancy associated with maternal-reported and observer-based measures of early relational health (ERH) and infant socio-emotional functioning at 4-6 months postpartum? Findings : Prenatal SARS-CoV-2 exposure was associated with a ∼5% reduction in observed quality of maternal caregiving after accounting for postnatal mental health symptomatology and sociodemographic factors. Meaning : A small reduction in maternal caregiving quality, but not other ERH constructs (parental stress, parenting confidence, bonding and emotional connection) or infant socio-emotional functioning, was associated with prenatal SARS-CoV-2 exposure. Results should be interpreted as hypothesis generating and will require replication in independent studies. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study was funded by the US Centers for Disease Control and Prevention through contract 75D30120C08150 with Abt Associates (Drs Gyamfi-Bannerman, Mourad, Stockwell, and Dumitriu), Einhorn Collaborative (Dumitriu), grant R01MH126531 from the National Institute of Mental Health (Drs Marsh, Monk, and Dumitriu), fellowships from the Canadian Institutes of Health Research and Fonds de Recherche en Sante du Quebec (Lavallee) and 1K99HD115784-01 from Eunice Kennedy Shriver National Institute of Child and Human Development (Lavallee). Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: IRB of Columbia University gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present study are available upon reasonable request to the authors. Copyright The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Back to top Previous Next Posted March 19, 2026. Download PDF Supplementary Material Data/Code Email Thank you for your interest in spreading the word about medRxiv. NOTE: Your email address is requested solely to identify you as the sender of this article. Your Email * Your Name * Send To * Enter multiple addresses on separate lines or separate them with commas. You are going to email the following Prenatal exposure to SARS-CoV-2, early relational health, and child socio-emotional functioning in the first 6 months Message Subject (Your Name) has forwarded a page to you from medRxiv Message Body (Your Name) thought you would like to see this page from the medRxiv website. Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Share Prenatal exposure to SARS-CoV-2, early relational health, and child socio-emotional functioning in the first 6 months Andréane Lavallée , Jennifer M. Warmingham , Jill B. Owen , Ruiyang L. Xu , Imaal Ahmed , Ginger D. Atwood , Margaret H Kyle , Maha Hussain , Vitoria Chaves , Elena Arduin , Marissa R. Lanoff , Sabrina P. Hyman , Lerzan Z. Coskun , Nicole Shearman , Jenna E. Russo , Sharon Ettinger , Esther A. Greeman , Danielle E. Serota , Mary L. Bence , Violet Hott , Yunzhe Hu , Georgia Kurman , Mayerly Lara , Helen Tzul Lopez , Isabelle Mollicone , Rupa Ravi , Cynthia Rodriguez , Grace C. Smotrich , Aoife Lawless , Perla Ontiveros-Ángel , Austen Curtin , Judy Austin , Morgan R. Firestein , Lauren C. Shuffrey , Cristina R. Fernández , Ashley N. Battarbee , Ann Bruno , Fatimah S. Dawood , Panagiotis Maniatis , Tyler C. Morrill , Gabriella Newes-Adeyi , Lawrence Reichle , Vera Semenova , Alan T. Tita , Michael Varner , Kristina Wielgosz , Rachel Marsh , Paul Curtin , Melissa S. Stockwell , Catherine Monk , Dani Dumitriu medRxiv 2026.03.12.26346895; doi: https://doi.org/10.64898/2026.03.12.26346895 Share This Article: Copy Citation Tools Prenatal exposure to SARS-CoV-2, early relational health, and child socio-emotional functioning in the first 6 months Andréane Lavallée , Jennifer M. Warmingham , Jill B. Owen , Ruiyang L. Xu , Imaal Ahmed , Ginger D. Atwood , Margaret H Kyle , Maha Hussain , Vitoria Chaves , Elena Arduin , Marissa R. Lanoff , Sabrina P. Hyman , Lerzan Z. Coskun , Nicole Shearman , Jenna E. Russo , Sharon Ettinger , Esther A. Greeman , Danielle E. Serota , Mary L. Bence , Violet Hott , Yunzhe Hu , Georgia Kurman , Mayerly Lara , Helen Tzul Lopez , Isabelle Mollicone , Rupa Ravi , Cynthia Rodriguez , Grace C. Smotrich , Aoife Lawless , Perla Ontiveros-Ángel , Austen Curtin , Judy Austin , Morgan R. Firestein , Lauren C. Shuffrey , Cristina R. Fernández , Ashley N. Battarbee , Ann Bruno , Fatimah S. Dawood , Panagiotis Maniatis , Tyler C. Morrill , Gabriella Newes-Adeyi , Lawrence Reichle , Vera Semenova , Alan T. Tita , Michael Varner , Kristina Wielgosz , Rachel Marsh , Paul Curtin , Melissa S. Stockwell , Catherine Monk , Dani Dumitriu medRxiv 2026.03.12.26346895; doi: https://doi.org/10.64898/2026.03.12.26346895 Citation Manager Formats BibTeX Bookends EasyBib EndNote (tagged) EndNote 8 (xml) Medlars Mendeley Papers RefWorks Tagged Ref Manager RIS Zotero Tweet Widget Facebook Like Google Plus One Subject Area Pediatrics Subject Areas All Articles Addiction Medicine (638) Allergy and Immunology (917) Anesthesia (350) Cardiovascular Medicine (4989) Dentistry and Oral Medicine (494) Dermatology (427) Emergency Medicine (675) Endocrinology (including Diabetes Mellitus and Metabolic Disease) (1689) Epidemiology (16248) Forensic Medicine (36) Gastroenterology (1241) Genetic and Genomic Medicine (7270) Geriatric Medicine (751) Health Economics (1093) Health Informatics (5280) Health Policy (1465) Health Systems and Quality Improvement (1830) Hematology (599) HIV/AIDS (1379) Infectious Diseases (except HIV/AIDS) (16480) Intensive Care and Critical Care Medicine (1201) Medical Education (699) Medical Ethics (156) Nephrology (751) Neurology (7581) Nursing (377) Nutrition (1127) Obstetrics and Gynecology (1295) Occupational and Environmental Health (1039) Oncology (3740) Ophthalmology (1091) Orthopedics (407) Otolaryngology (465) Pain Medicine (500) Palliative Medicine (143) Pathology (721) Pediatrics (1856) Pharmacology and Therapeutics (755) Primary Care Research (785) Psychiatry and Clinical Psychology (6120) Public and Global Health (9977) Radiology and Imaging (2526) Rehabilitation Medicine and Physical Therapy (1514) Respiratory Medicine (1268) Rheumatology (658) Sexual and Reproductive Health (803) Sports Medicine (595) Surgery (801) Toxicology (109) Transplantation (318) Urology (307)

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