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Neurodevelopment and Risk Factors in Infants Before, During, and After the COVID-19 Pandemic in Eastern China:
Yuechong Cui1,2, Shuting Si2, Guannan Bai3
1Department of Children's and Adolescent Health, Public Health College, Harbin Medical University, Harbin, China.
Insights
The COVID-19 pandemic increased infant neurodevelopmental delays, with risks continuing post-pandemic. Early interventions are crucial for mitigating long-term effects on child development.
Area of Science:
- Pediatric Neurodevelopment
- Epidemiology
- Public Health
Background:
- Emerging evidence suggests a link between COVID-19 pandemic exposure and heightened risks of neurodevelopmental disorders in infants.
- Population-based studies on these associations in Chinese contexts, especially post-pandemic, are limited.
Purpose of the Study:
- To analyze dynamic changes in infant neurodevelopment in eastern China across different COVID-19 pandemic phases.
- To identify key risk factors contributing to infant neurodevelopmental delays.
Main Methods:
- Cross-sectional study of 17,621 Peabody Developmental Motor Scales-II (PDMS-II) and 7877 Bayley Scales of Infant Development-Chinese Cities Revised (BSID-CR) assessments (Jan 2019-Jul 2023).
- Multivariate logistic regression analyzed associations between pandemic phases (prepandemic, pandemic, postpandemic), seasonality, and perinatal variables with neurodevelopmental outcomes.
Main Results:
- Infants during the pandemic (stage II) and postpandemic (stage III) showed significantly higher risks of neurodevelopmental delays compared to the prepandemic phase.
- The postpandemic phase exhibited the highest risk for mental development delay.
- Cesarean delivery, male gender, and low birth weight were identified as independent risk factors for neurodevelopmental delay.
Conclusions:
- The COVID-19 pandemic significantly exacerbated infant neurodevelopmental vulnerabilities, with effects persisting into the postpandemic era.
- Public health strategies focusing on early interventions are recommended to address these long-term impacts.
Background:
Emerging studies suggest that exposure to the COVID-19 pandemic may have heightened the risks of neurodevelopmental disorders in infants (0-1-year-old); however, population-based studies investigating these associations in Chinese contexts remain scarce, particularly including the postpandemic phase.
Objective:
The aim of this study was to characterize the dynamic changes in neurodevelopment among infants in eastern China during distinct phases of the COVID-19 pandemic and to identify the critical risk factors associated with infant neurodevelopmental delays.
Methods:
This cross-sectional study analyzes 17,621 Peabody Developmental Motor Scales-II (PDMS-II) assessments and 7877 Bayley Scales of Infant Development-Chinese Cities Revised (BSID-CR) scores of infants who visited a tertiary maternal and children hospital for routine neurodevelopment assessment from January 2019 to July 2023. Multivariate logistic regression models were used to evaluate the associations of COVID-19 pandemic phases (stage I: prepandemic, January 2, 2019, to January 22, 2020; stage II: pandemic, January 23, 2020, to December 18, 2022; and stage III: postpandemic, December 19, 2022, to July 31, 2023), seasonal variations, and perinatal variables (eg, delivery mode, birth weight, gender) with the neurodevelopmental outcomes.
Results:
Infants assessed at stage II of the COVID-19 pandemic had a higher risk of neurodevelopmental delay compared to infants assessed at stage I (total motor quotient: odds ratio [OR] 2.84, 95% CI 2.17-3.72; fine motor quotient: OR 2.71, 95% CI 1.99-3.68) and stage III (total motor quotient, OR 2.52, 95% CI 1.79-3.55; gross motor quotient: OR 1.65, 95% CI 1.21-2.25; fine motor quotient: OR 3.40, 95% CI 2.36-4.92). Infants assessed at stage III had the highest risk of mental development delay (OR 2.54, 95% CI 1.91-3.36). In addition, cesarean delivery, male gender, and low birth weight were independent risk factors of neurodevelopmental delay (P<.05).
Conclusions:
The COVID-19 pandemic exacerbated neurodevelopmental vulnerabilities in infants, persisting into the postpandemic period. Public health strategies should mitigate the long-term effects through early interventions.
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