JMIR Public Health Surveill. 2025 Nov 10. doi: 10.2196/76431. Online ahead of print.
ABSTRACT
BACKGROUND: Emerging studies suggests that exposure to the COVID-19 pandemic may heighten risks of neurodevelopmental disorders in infants (0~1 years old), however, population-based studies investigating these associations in Chinese contexts remain scarce, particularly including the post-pandemic phase.
OBJECTIVE: To characterize dynamic changes in neurodevelopment among infants in eastern China during distinct phases of the COVID-19 pandemic, and identify critical risk factors associated with infant neurodevelopmental delays.
METHODS: This cross-sectional study analyzed 17,621 Peabody Developmental Motor Scales-II (PDMS-II) assessments and 7,877 Bayley Scales of Infant Development-Chinese Cities Revised (BSID-CR) from 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 associations between COVID-19 pandemic phases (Stage I (Pre-pandemic: 02 January, 2019 to 22 January, 2020), Stage II (Pandemic: 23 January, 2020 to 18 December, 2022), and Stage III (Post-pandemic: 19 December 2022 to 31 July 2023).), seasonal variations, and perinatal variables (e.g., delivery mode, birth weight, gender) with 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% confidential interval (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 section, male gender and low birth weight were independent risk factors of neurodevelopmental delay (P values <0.05).
CONCLUSIONS: The COVID-19 pandemic exacerbated neurodevelopmental vulnerabilities in infants, persisting into the post-pandemic period. Public health strategies should mitigate long-term effects through early interventions.
PMID:41217003 | DOI:10.2196/76431
