ArticleJMIR public health and surveillance2025
Neurodevelopment and Risk Factors in Infants Before, During, and After the COVID-19 Pandemic in Eastern China: Cross-Sectional Study.
Article in JMIR public health and surveillance, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEmerging 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.
objectiveThe 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.
methodsThis 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.
resultsInfants 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).
conclusionsThe 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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