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

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 impact of pandemic-related stress on the 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), matched for age, gestational age and birthweight, 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). Pandemic-related stress 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 Wilcoxon rank-sum 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**). Within the pandemic cohort, significant interactions between the Corona-Index and sex were found for cognitive (p = 0.049*) and motor development (p = 0.026*). Girls were more negatively affected by pandemic-related stress, whereas the effects on boys were minimal. Boys scored significantly lower than girls for language development (p = 0.032*), but no interaction with the Corona-Index emerged. Conclusion Overall, preterm children assessed during the pandemic showed reduced language performance, which may be due to reduced social interaction and limited facial cues caused by mask-wearing. Pandemic-related stress particularly impacted girls’ cognitive and motor outcomes, highlighting the importance of maintaining social and developmental stimulation during societal restrictions.