A cross-sectional investigation of psychosocial stress factors in German families with children aged 0-3 years during the COVID-19 pandemic: initial results of the CoronabaBY study

Understanding the impact of children's and young people's self-harm on parental well-being: a systematic literature review of qualitative and quantitative findings

BACKGROUND

Self-harm in children and young people is increasing. Parents are vital in supporting young people; however, parents may experience distress linked to the self-harm. Previous reviews have highlighted the emotional impact and need for information and support, however, have not elucidated the relationships between these themes, nor examined the quantitative data examining parents' well-being.

METHODS

We conducted a mixed methods review, with qualitative meta-synthesis focusing on links between themes and quantitative synthesis of parental well-being findings, including pooled means. PsycInfo, Medline, EMBASE, AMED, CINHAL and Web of Science were searched to identify relevant records. References of included studies were also searched. Every abstract was screened by two authors. Data were extracted by one author and checked by another.

RESULTS

We identified 39 reports of 32 studies: 16 with qualitative data and 17 with quantitative data (one had both). Qualitative findings showed how parents' emotions were associated to their knowledge and beliefs about self-harm. Parents' emotions often evidenced the need to self-care, but emotions of guilt reduced engagement in self-care. How parents supported their young person was linked to their knowledge, and the management of their own emotions, and influenced if they could engage in self-care. Quantitative findings were mixed, however suggested poor general mental health amongst these parents.

CONCLUSIONS

Further good quality quantitative studies are needed, with measurement of psychological mechanisms that may underpin parental distress. Current evidence supports peer-support and interventions that go beyond information provision to address the connected factors of knowledge, emotion, self-care, and parenting behaviours.

Correlation of screen exposure to stress, learning, cognitive and language performance in children

The omnipresence of mobile screens and convenience to operate them has led to increased screen time for young children whereas the sequelae of prolonged exposure are not known yet. 70 refugee children (RG) and 111 children of a clinical comparison group (CG) from a help-seeking population (age: M = 5.10; SD = 1.11; range 3.00-6.97 years) were assessed concerning their amount of daily screen exposure time in relation to parental education and distress. Salivary cortisol was collected as a marker for biological stress and children were tested concerning learning performance, non-verbal IQ and vocabulary with the Kaufmann Assessment Battery for Children (KABC-II). Language skills were assessed in educator rating. The amount of children's screen exposure was negatively related to parental education and positively to distress. In the CG, higher amounts of screen time were associated with elevated cortisol levels and lower learning scores. On both measures, the RG and CG only differed in the condition of screen time less than one hour/day, for higher amounts of screen time the CG approached the more problematic scores of the RG. Whereas in the whole sample the amount of screen time was negatively correlated to language performance, it was not correlated to non-verbal IQ-scores. As a higher amount of media exposure in our clinical comparison group is associated with elevated biological stress, decreased learning and lower language performance, it should be classified as a relevant environmental factor and regularly considered in clinical assessments of children and therapeutical interventions, especially in vulnerable subgroups. German clinical trials register, registration number: DRKS00025734, date: 07-23-2021.

Assessment of Psychosocial Stress and Mental Health Disorders in Parents and Their Children in Early Childhood: Cross-Sectional Results from the SKKIPPI Cohort Study

BACKGROUND/OBJECTIVES

Early childhood can be a stressful period for families with a significant impact on parents' mental health, the child's healthy development, and the development of a secure mother-child attachment. The goal of the cross-sectional study part of SKKIPPI was to assess the occurrence of psychosocial stress and mental health disorders in parents as well as in their offspring in early childhood in three German regions.

METHODS

Based on random samples from three residents' registration offices, parents with infants aged up to 12 months were invited to participate. An online screening questionnaire was developed in four languages to assess common psychosocial stressors and mental health problems of parents with small children.

RESULTS

The study enrolled 4984 mothers and 962 fathers. The most common potential psychosocial stressors were professional problems (mothers 22%, fathers 33%), lack of social support (20%, 14%), and severe, negative experiences in childhood (22%, 16%). Obsessive-compulsive thoughts (21%, 16%) and depressive (9%, 9%) and anxiety symptoms (11%, 7%) were the most frequently reported mental health problems by both parents. Regulatory problems of the child were reported by between 1.5% and 5.1% of parents.

CONCLUSIONS

The study showed that a substantial proportion of parents are burdened by psychosocial problems and suffer from mental health problems in the first years after the birth of their children. Early preventive and low-threshold support measures should be available in the health and social care system. Low-threshold questionnaires, which cover a wide range of possible stress factors, should be further developed for the practical healthcare of this group of people.

Impact of COVID-19 on emotional and behavioral problems among preschool children: a meta-analysis

The impact of the Coronavirus Disease 2019 (COVID-19) on society is continuous, resulting in negative psychological consequences. Given the vulnerability and sensitivity to the environment among preschool children, their emotional and behavioral problems deserve more attention. The current study aimed to explore the impact of the epidemic on preschool children's mental health by determining the pooled prevalence of emotional and behavioral problems amidst the Coronavirus Disease 2019 pandemic and to reveal potential reasons for variations between studies. Published studies were searched in Embase, PubMed, ProQuest, PsycINFO, Web of Science, CNKI, and Wanfang. Based on the inclusion criteria outlined in this study, a total of 10 studies encompassing 38,059 participants were incorporated. Employing a random-effect model for estimating the prevalence of emotional and behavioral problems, the results revealed a pooled prevalence rate of 24.3% (95% CI, 0.15-0.38; I²=99.9%) among preschool children. This rate surpasses the pre-outbreak prevalence observed in different countries, signifying a detrimental influence of the epidemic on the mental well-being of preschoolers. Therefore, mental health care and recovery are essential for the vulnerable group during and after the public health crisis. Specific emotional and behavioral problems among preschool children are expected to be researched in the future to provide more targeted guidance for intervention.

Investigation of Malocclusion and Associated Factors in Preschoolers: A Cross-Sectional Questionnaire Study

This study aims to describe the prevalence of malocclusion and identify associated factors in preschool children. Completed in 2022-2023, this cross-sectional study included 523 children aged 26 to 80 months in municipal schools in Salvador. An oral examination was carried out on the children, and a questionnaire was self-administered by the parents. Descriptive analyses and multivariate logistic regression (the backward method, p-value ≤ 0.05, 95% CI) were conducted. The majority of children were female (51.82%), over 54 months old (52.2%), Black or mixed race (90.63%), and not affected by COVID-19 (92.35%). The prevalence of malocclusion was 43.21%, with open bite as the most common condition. There was a significant association between malocclusion and screen time (OR: 1.34; p: 0.116; CI: 1.0-1.94), physical/psychological aggression (OR: 2.55; p: 0.031; CI: 1.0-5.98), consumption of ultra-processed foods (OR: 1.77; p: 0.003; CI: 1.22-2.57), digital suction (OR: 3.1; p: 0.001; CI: 1.56-6.16), and the habit of biting objects (OR: 1.56; p: 0.121; CI: 1.0-2.73). The promotion of comprehensive health in early childhood and psychosocial interventions are recommended, aiming to reduce screen time, aggression, consumption of ultra-processed foods, thumb sucking, and the habit of biting objects to prevent malocclusion.

Sleep initiation patterns and sleep quality among toddlers in the southeast of China: initial study results

BACKGROUND

A large number of psychological consequences including sleep health emerged during the 2019 Coronavirus disease (COVID-19) pandemic. Sleep patterns in toddlers are vulnerable to negative environmental exposures, however, very few studies on this topic have been published so far.

OBJECTIVES

In this paper, we aimed to investigate the sleep patterns and associated factors in toddlers from China confined at home in the context of COVID-19 pandemic.

METHODS

From April to November 2021, a convenience sample of 493 parents of young children aged (12-35 months) were surveyed from Fuzhou, Sanming, Quanzhou, Nanping, and Longyan cities in the Fujian Province, China. A cross-sectional survey was conducted via Electronic questionnaires to collect parent and child social-demographic characteristics. The Brief Infant Sleep Questionnaire (BISQ) was used to collect data on sleep practices, sleep duration and patterns, as well as the number of nocturnal awaking .

RESULTS

The mean age of toddlers was 2.11 years old, and 52.54% (259/493) were males. Among the 493 toddlers' sleep patterns, 331(67.1%) initiated sleep accompanied by parents, 67(13.6%) slept independently, 59 (12.0%) were breast fed/bottle fed to initiate sleep, 27 (5.5%) were held and 9 (1.8%) rocked. The clear longitudinal association between the duration of night-time sleep, the frequency of nighttime awakenings, and various sleep patterns remains clear (p < 0.05). Multiple linear regression analysis indicated that sleep initiation with bottle-feeding/breast-feeding and rocked significantly increased the frequency of nighttime awakenings and reduced the duration of nighttime sleep (p < 0.05), as held was dramatically only for increasing the number of nighttime awakenings (p < 0.05). Multi-variate logistic regression analysis demonstrated that toddlers with severe sleep difficulties had a higher probability of being rocked to initiate sleep (p < 0.05). Conversely, young children with minor sleep problems were more apt to be in bed alone to initiate sleep (p < 0.05).

CONCLUSIONS

During the COVID-19 pandemic, most infants and toddlers initiated sleep accompanied by parents and tend to have electronic media exposure before bedtime. Increased waking at night may be associated with sleep initiation with breast-feeding/bottle-feeding. Therefore, pediatric practitioners in primary community hospitals should pay attention to the education and promotion of sleep hygiene and parenting knowledge of young children to avoid the formation of poor sleep hygiene habits.

Pediatric Traumatic Brain Injury Outcomes and Disparities During the COVID-19 Pandemic

BACKGROUND

To study the impact of the COVID-19 pandemic on traumatic brain injury (TBI) patient demographic, clinical and trauma related characteristics, and outcomes.

METHODS

Retrospective chart review was conducted on pediatric TBI patients admitted to a Level I Pediatric Trauma Center between January 2015 and June 2022. The pre-COVID era was defined as January 1, 2015, through March 12, 2020. The COVID-19 era was defined as March 13, 2020, through June 30, 2022. Bivariate analysis and logistic regression were performed.

RESULTS

Four hundred-thirty patients were treated for pediatric TBI in the pre-COVID-19 period, and 166 patients during COVID-19. In bivariate analyses, the racial/ethnic makeup, age, and sex varied significantly across the two time periods (p < 0.05). Unwitnessed TBI events increased during the COVID-19 era. Logistic regression analyses also demonstrated significantly increased odds of death, severe disability, or vegetative state during COVID-19 (AOR 7.23; 95 % CI 1.43, 36.41).

CONCLUSION

During the COVID-19 pandemic, patients admitted with pediatric TBI had significantly different demographics with regards to age, sex, and race/ethnicity when compared to patients prior to the pandemic. There was an increase in unwitnessed events. In the COVID period, patients had a higher odds ratio of severe morbidity and mortality despite adjustment for confounding factors.

LEVEL OF EVIDENCE AND STUDY TYPE

Level II, Prognosis.

The change of psychosocial stress factors in families with infants and toddlers during the COVID-19 pandemic. A longitudinal perspective on the CoronabaBY study from Germany

Background

Over nearly three years, the COVID-19 pandemic has had a lasting impact on people's lives and mental health worldwide with its far-reaching restrictions and concerns about infections and other personal consequences. Families were particularly affected and showed increased stress and psychological problems. Long-term effects cannot be ruled out. So far, data on young families are sparse. The present longitudinal analysis (n = 932) of the CoronabaBY study investigated the development of parenting stress, parental affective symptoms, and child's mental health in young families with children aged 0-3 years in Germany as well as potential influencing factors.

Methods

The observational study includes two measurement points over the course of the pandemic (baseline and follow-up). Data was collected by app using standardized questionnaires.

Results

N = 932 participants, mainly mothers (94.7%) born in Germany (93.1%) with higher education (61.3% with at least high school diploma) and a comfortable financial situation participated in the longitudinal study. Children were on average 14.7 months old at baseline (SD: 12, range: 1-39 months). While the proportion of parents who perceived the pandemic as stressful decreased significantly from baseline (60%) to follow-up (52.3%), the proportion with parenting stress increased significantly (from 40.1% to 45.4%). Both parental and child mental health problems remained constant over time, with infants crying/feeding/sleeping problems ranging above pre-pandemic comparative data. Most predictive for high parenting stress at follow-up was high parenting stress at baseline. This was also true for parental affective symptoms (depression/anxiety) and child mental health problems.

Conclusions

Despite faded pandemic restrictions, parents remained burdened. Support services do not appear to have been sufficient to help families out of their stressful situation. Our results indicate a need for action regarding low-threshold services that effectively reach affected families.

Trial registration

The study was pre-registered in OSF (https://osf.io/search/?q=tksh5&page=1).

Long-Term Outcome of Neonates and Infants whose Mothers Tested Positive for SARS-CoV-2 during Pregnancy - a Pilot of the Post-CRONOS Project

OBJECTIVE

Long-term effects on infants of mothers with SARS-CoV-2 infection during pregnancy are increasingly discussed in the literature. Besides potential neurodevelopment impairments after intrauterine SARS-CoV-2 exposure, there might be differences in the postnatal pediatric care of those children, like the timing of preventive medical examinations (PME) or vaccinations. In this first national long-term follow-up study of women included in the CRONOS registry, we describe maternal impressions of their child´s development and the prevalence of regulatory disorders, and we analyze the timing of PMEs and vaccinations.

METHODS

773 women who were enrolled between April 3, 2020, and August 24, 2021, in the CRONOS registry were eligible to be contacted by the study coordinators and asked to fill out a web-based questionnaire.

RESULTS

110/773 (14%) women completed the questionnaire. Their children were between the ages of 12 and 31 months (median 20 months). All mothers were satisfied with their child´s development, milestones were achieved in a timely fashion. The reported prevalence for excessive crying, sleeping, and feeding disorders was 11%, 18-32%, and 7%, respectively. PMEs were mostly not delayed, but only 54% of infants received their first vaccination within their first 60 days of life.

DISCUSSION

  In summary, our exploratory findings suggest that developmental milestones in infancy are reached in time after maternal SARS-CoV-2 infection during pregnancy. However, there are effects on the implementation of PMEs and vaccinations. EINFüHRUNG: In der Literatur werden zunehmend potenzielle Langzeitfolgen für Säuglinge nach intrauteriner SARS-CoV-2-Exposition diskutiert. Neben möglichen Beeinträchtigungen der neurologischen Entwicklung können Unterschiede in der pädiatrischen postnatalen Betreuung bei diesen Kindern z. B. bei der Durchführung von Vorsorgeuntersuchungen (sog. U´s) oder Impfungen bestehen. In dieser ersten nationalen Langzeit-Follow-up-Studie aus dem CRONOS-Register beschreiben wir mütterliche Eindrücke zur Entwicklung ihres Kindes, sowie die Prävalenz von Regulationsstörungen. Wir analysieren den Zeitpunkt von U´s und Impfungen.

METHODEN

773 Frauen, die zwischen dem 03.04.2020 und dem 24.08.2021 in CRONOS aufgenommen wurden, wurden von den Studienkoordinatoren kontaktiert und gebeten, einen webbasierten Fragebogen auszufüllen.

ERGEBNISSE

110/773 (14%) Frauen füllten den Fragebogen aus, ihre Kinder waren zwischen 12 und 31 Monate alt (Median 20 Monate). Alle Mütter waren mit der Entwicklung ihres Kindes zufrieden, Meilensteine der Entwicklung wurden zeitgerecht erreicht. Die berichtete Prävalenz für exzessives Schreien, Schlaf- und Fütterstörungen betrug 11%, 18-32% bzw. 7%. U´s wurden meist zeitgerecht durchgeführt, aber nur 54% der Säuglinge erhielten ihre erste Impfung innerhalb der ersten 60 Lebenstage.

DISKUSSION

Zusammenfassend deuten unsere explorativen Ergebnisse darauf hin, dass Entwicklungsmeilensteine im Säuglingsalter nach mütterlicher SARS-CoV-2-Infektion in der Schwangerschaft rechtzeitig erreicht werden. Es zeigen sich jedoch Auswirkungen auf die Durchführung von Vorsorgen und Impfungen.

COVID-19 pandemic and language development in children at 18 months: a repeated cross-sectional study over a 6-year period in Japan

OBJECTIVE

To evaluate the impact of the COVID-19 pandemic experience on language development among children, we compared language development at 18 months of age, before and during the pandemic in Japan, where strict control measures continued over a long period.

METHODS

This was a repeated cross-sectional study and we included children who attended the 18-month health check-up provided by the Okayama City Public Health Center between January 2017 and December 2022 (n=33 484). We compared indicators of language development before (from January 2017 to February 2020) and during (from March 2020 to December 2022) the pandemic. Our primary outcome was the proportion of children who required follow-up for language development by the Public Health Center. The secondary outcome was the proportion of children who could not say three or more meaningful words. We estimated risk ratios (RRs) and their 95% CIs, adjusted for potential confounders.

RESULTS

The prevalence of the primary outcome was 33.5% before the pandemic and 36% during the pandemic. Compared with before the pandemic, increased RRs for the primary and secondary outcomes were observed during the pandemic, with RRs (95% CIs) of 1.09 (1.06-1.13) for the primary outcome and 1.11 (1.05-1.17) for the secondary outcome. Although the statistical interactions were not significant, the RRs were higher for children cared for at home than those in nursery schools and with ≤3 family members than those with ≥4 family members.

CONCLUSIONS

The COVID-19 pandemic was associated with an increased risk of impaired language development in children at 18 months. More extensive support is needed for higher risk families, as well as follow-up of long-term language development in children affected by the COVID-19 pandemic.

[Families with infants and toddlers in the COVID-19 pandemic: parental stress and child development considering social class]

INTRODUCTION

It is now well established empirically that families and children who could not attend educational and childcare institutions during the COVID-19 pandemic experienced disadvantages. This is particularly true for families in poverty. However, little is known about the situation of families with young children. The aim of the paper is to investigate (1) to what extent families with infants and toddlers also experienced their situation during the pandemic as stressful, (2) whether there were differences depending on social class, (3) how the pandemic affected the healthy development of infants and toddlers, and (4) to what extent class-related differences can also be identified in this.

METHODS

The German National Centre for Early Prevention conducted a nationally representative survey of families with children of age 0 to 3 years in April to December 2022, "Kinder in Deutschland 0‑3 2022" (N = 7821). The KiD 0‑3 study combines a parent survey on family psychosocial burden and resources with pediatric documentation of child development.

RESULTS

Parents with very young children experienced their situation in the COVID-19 pandemic as stressful. A clear difference depending on social class emerged. Both from the parents' perspective and in pediatric judgment, the pandemic had a negative impact on social and affective development even in young children. These effects were more pronounced in children from families experiencing poverty than in children from families not receiving basic government benefits.

DISCUSSION

In order to mitigate the psychosocial consequences of the COVID-19 pandemic for families and to improve children's chances of growing up in a healthy way that promotes their development, it is necessary to support families in need without stigmatization.

[Early childhood mental disorders: excessive crying, sleep and feeding disorders, and interventions using the "Munich model" as an example]

About 20% of all healthy infants and toddlers show problems in the area of mental health during their first years of life such as inconsolable crying (so-called cry-babies), sleeping problems, and feeding problems. The prevalence of enduring feeding problems and sleeping problems is distinctly higher in premature children and in children with neuropediatric disorders. These problems present a higher risk for the development of internalizing and externalizing disorders of mental health in later childhood. The parent-child relationship is often strained. Parents report experiencing severe exhaustion, extreme uncertainty, and helplessness.Pediatricians and midwives are the first points of contact for families. Outpatient clinics for cry-babies such as the "Munich Consultation for Cry-Babies," founded by Mechthild Papoušek in 1991 at the kbo-Children's Center Munich, provide a low-threshold service for the highly stressed families. They can contribute to the prevention of neglect, maltreatment, and psychological secondary disorders of the child. Intervention strategies are based on parent-infant and attachment research and integrate child- and parent-oriented approaches.During the COVID-19 pandemic, psychosocial stress factors in families increased. This development was also observable in the outpatient clinics for cry-babies.

Easing pandemic-related restrictions, easing psychosocial stress factors in families with infants and toddlers? Cross-sectional results of the three wave CoronabaBY study from Germany

BACKGROUND

Families with young children are particularly vulnerable for the stressors induced by the COVID-19 pandemic. However, studies on their psychosocial situation during the course of the crisis are still sparse.

METHODS

In a comparison of three survey waves (wave I and III = high COVID-19 incidences), we cross-sectionally investigated the proportion of families (N_total = 2940) with children aged 0-3 years experiencing pandemic burden, parenting stress, and parental and child mental health problems in relation to COVID-19 incidences and restrictions in Southern Germany via validated questionnaires. Potential influencing factors were also explored.

RESULTS

The number of parents with a high pandemic burden decreased over the course of the pandemic with a peak of 65.3% in wave I (significant changes except wave II versus III). Participants with high parenting stress significantly increased from 38.2% in wave I to 51.2% in wave III. The number of parents with symptoms of depression and anxiety remained constantly high with a maximum of 28.4% being affected. Infants with crying/sleeping problems increased significantly from 26.4% in wave I to 35.5% in wave III. Toddlers' emotional and behavioral problems showed a peak of 23.9% in wave III (no significant changes). Increased family conflicts were the strongest predictor for parenting stress (ß = 0.355), maternal (ß = 0.305), infants' (ß = 0.149) and toddlers' (ß = 0.216) mental health problems during the pandemic.

CONCLUSIONS

Psychosocial stress factors in families with infants and toddlers remained highly pronounced and even partly increased irrespective of pandemic events. The findings suggest a staggered negative impact of pandemic-related factors on young children's mental health. Promoting infants' mental health as well as strengthening parental resources by reducing parenting stress should be a top healthcare priority in the aftermath of COVID-19. Trial registration The study was pre-registered in OSF ( https://osf.io/search/?q=tksh5&page=1 ).

Mental Health Is a Family Affair-Systematic Review and Meta-Analysis on the Associations between Mental Health Problems in Parents and Children during the COVID-19 Pandemic

As a multidimensional and universal stressor, the COVID-19 pandemic negatively affected the mental health of children, adolescents, and adults worldwide. In particular, families faced numerous restrictions and challenges. From the literature, it is well known that parental mental health problems and child mental health outcomes are associated. Hence, this review aims to summarize the current research on the associations of parental mental health symptoms and child mental health outcomes during the COVID-19 pandemic. We conducted a systematic literature search in Web of Science (all databases) and identified 431 records, of which 83 articles with data of over 80,000 families were included in 38 meta-analyses. A total of 25 meta-analyses resulted in significant small to medium associations between parental mental health symptoms and child mental health outcomes (r = 0.19 to 0.46, p < 0.05). The largest effects were observed for the associations of parenting stress and child mental health outcomes. A dysfunctional parent-child interaction has been identified as a key mechanism for the transmission of mental disorders. Thus, specific parenting interventions are needed to foster healthy parent-child interactions, to promote the mental health of families, and to reduce the negative impacts of the COVID-19 pandemic.

COVID-19 Pandemic and Infant Neurodevelopmental Impairment: A Systematic Review and Meta-analysis

IMPORTANCE

Primary studies proposed that aberrant maternal antiviral immunity and/or giving birth in quarantine, such as during the ongoing COVID-19 pandemic, may be associated with the risk of neurodevelopmental impairment (NDI) in offspring.

OBJECTIVES

To evaluate the associations of birth and being raised during the COVID-19 pandemic with risk of NDI among infants and to assess the association of gestational exposure to SARS-CoV-2 with risk of NDI.

DATA SOURCES

PubMed, Web of Science, Scopus, Embase, and preprint servers were systematically searched from inception to March 25, 2022.

STUDY SELECTION

Studies evaluating the neurodevelopment of infants born during the SARS-CoV-2 pandemic were included in this systematic review and meta-analysis. Studies using Ages and Stages Questionnaires, Third Edition (ASQ-3), were used for quantitative meta-analysis.

DATA EXTRACTION AND SYNTHESIS

Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses, a random-effects model meta-analysis was used to pool the proportion and odds ratios (ORs) of overall NDI, as well as each developmental domain on ASQ-3 with the corresponding 95% CI.

MAIN OUTCOMES AND MEASURES

The primary outcome was the risk of overall NDI among infants screened during the pandemic vs prepandemic. The secondary outcome was the comparison of NDI by ASQ-3 domain among infants born to women with known gestational exposure to SARS-CoV-2 vs no exposure.

RESULTS

A total of 8 studies were included, including 21 419 infants (11 438 screened in pandemic and 9981 in prepandemic period). NDI was present in 330 of 8992 infants (7%; 95% CI, 4%-10%) screened during the COVID-19 pandemic from January 2020 to January 2021. Among the pandemic cohort, the prevalence of NDI among infants with gestational exposure to SARS-CoV-2 was 77 of 691 (12%; 95% CI, 6%-18%). Compared with the prepandemic cohort (2015-2019), the pandemic cohort was more likely to have communication impairment (OR, 1.70; 95% CI, 1.37-2.11; P < .001), without significant differences in other ASQ-3 domains (eg, gross motor, fine motor, personal-social, and problem-solving). In contrast, maternal SARS-CoV-2 infection was not associated with significant differences in any neurodevelopment domain in offspring, except for increasing the odds of fine motor impairment (OR, 3.46; 95% CI, 1.43-8.38; P < .001).

CONCLUSIONS AND RELEVANCE

In this systematic review and meta-analysis examining the association between COVID-19 pandemic and the risk of NDI, findings suggest that overall neurodevelopment in the first year of life was not changed by either being born or raised during the SARS-CoV-2 pandemic or by gestational exposure to SARS-CoV-2. Interestingly, the first year of life during the COVID-19 pandemic, regardless of maternal infection, was significantly associated with the risk of communication delay among the offspring.