The effects of the pandemic burden on early developmental outcomes in preterm children aged 0–3 years: a cross-sectional study

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BACKGROUND: The psychosocial stress experienced by families with young children during the pandemic raised concerns about developmental risks, particularly for preterm infants, who are highly sensitive to environmental influences. This study examined the association between parent-reported pandemic burden and cognitive, language and motor development of preterm children. METHODS: Between 2022 and 2023, a total of 69 children (median corrected age: 21.59 months) were assessed, 62.3% of whom were born prematurely. A subset of these preterm children (n = 31), restricted to improve age alignment, was compared to a pre-pandemic cohort (n = 40; median age: 22.2 months). Development was measured using the Bayley Scales of Infant and Toddler Development (Second and Third Edition). The pandemic burden was quantified using the Corona-Index, which was based on a standardised parental questionnaire. Multiple linear regressions were conducted with the Corona-Index as the main predictor and sex, gestational age, socioeconomic status and parental stress as moderators. Group differences were analysed using Mann-Whitney-U-Tests. RESULTS: Cognitive and motor scores did not differ significantly between cohorts, whereas language scores were significantly lower in the pandemic group (p = 0.001). The overall regression models for cognitive and language development did not reach statistical significance, and their sub-analyses should be interpreted with caution. Within the pandemic cohort, a significant interaction between the Corona-Index and sex was found for motor development (p = 0.022). Exploratory interaction effects suggested possible sex-related differences. CONCLUSION: Overall, preterm children assessed during the pandemic showed differences in language scores compared to the pre-pandemic control group, which may theoretically be linked to altered social environments. However, instrument-related variability and residual clinical confounding cannot be excluded. Exploratory analyses highlighted the importance of examining sex-specific patterns in the context of environmental disruptions.

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