# Long term adverse health outcomes for women and children following SARS-CoV-2 infection during pregnancy

> **NIH NIH R01** · KAISER FOUNDATION RESEARCH INSTITUTE · 2024 · $802,563

## Abstract

Project Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the virus responsible for the global
COVID-19 pandemic of unprecedented scale causes a multi-organ disease with widespread effects. Increasing
evidence suggests long-term effects of SARS-CoV-2 infection in some individuals present up to a year after
initial infection, referred to as Post-Acute Sequelae of SARS-CoV-2 (PASC). Pregnant women and their
fetuses may be particularly vulnerable to the long-term effects of SARS-CoV-2 infection. The biological
plausibility and emerging epidemiological evidence from SARS-CoV-2 infections in the population highlight the
urgent need for research on the long-term effects of SARS-CoV-2 infection during pregnancy on women’s
cardiometabolic and neuropsychiatric health outcomes and children’s growth and development. Limitations of
current studies of both pregnant women with SARS-CoV-2 infection and their children exposed in utero,
include a lack of long-term follow-up, lack of data on pre-existing conditions making it difficult to disentangle
risk factors for the infection from its consequences, and limited ability to examine associations by predominant
SARS-CoV-2 variant and vaccination status. The proposed study leverages Kaiser Permanente Northern
California’s (KPNC’s) high-quality electronic health records (EHR) data on SARS-CoV-2 infection testing and
results to assemble a longitudinal pregnancy cohort of >195,000 pregnant women (>22,000 women with
SARS-CoV-2 infection during pregnancy and approximately>173,000 without) between March 2020 and
December 2022. We will use our robust and comprehensive EHR to follow women and their children for up to 5
years and ascertain clinical diagnoses data. Additionally, we will recruit and survey a subsample of 2000 of the
mother-child dyads when the child is 3 years old to ascertain women’s and children’s self/parent-reported
subclinical health outcomes not available in the EHR, but that may suggest a need to monitor and/or provide
early interventions. We will randomly identify 1000 dyads with SARS-CoV-2 infection during pregnancy (1/3
early variants, 1/3 Delta and 1/3 Omicron variants) and 1000 dyads without SARS-CoV-2 infection during
pregnancy. Our study will assess the following: 1) Evaluate the long-term effects of a SARS-CoV-2 infection
during pregnancy on women’s cardiometabolic and neuropsychiatric outcomes (EHR and self-report), and 2)
Evaluate the long-term effects of in utero exposure to SARS-CoV-2 infection on child growth trajectory and
neurodevelopment (EHR and parent-report). We will examine variant, severity of infection and gestational age
at infection in relation to all outcomes of interest and explore effect modification by vaccination status,
race/ethnicity and pre-existing co-morbidities. Finally, our analyses will include infection status before, during
and after pregnancy or birth allowing for estimation of joint effects. This project will fill a significant gap
i...

## Key facts

- **NIH application ID:** 10873260
- **Project number:** 5R01AI178009-02
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Lyndsay Ammon Avalos
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $802,563
- **Award type:** 5
- **Project period:** 2023-07-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10873260

## Citation

> US National Institutes of Health, RePORTER application 10873260, Long term adverse health outcomes for women and children following SARS-CoV-2 infection during pregnancy (5R01AI178009-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10873260. Licensed CC0.

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