Neurodevelopment and Risk Factors in Infants Before, During, and After the COVID-19 Pandemic in Eastern China: Cross-Sectional Study
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".