COVID-19 pandemic and the neurodevelopment of Brazilian infants: Analysis of predictors according to the Nurturing Care Framework.

Introduction: Concerns have been raised about the potential negative impacts of the COVID-19 pandemic on child development; this issue can be analyzed using the Nurturing Care Framework (NCF).

Objective: To analyze the predictors of neurodevelopment at 12 months in infants born during the pandemic in Brazil, according to the NCF.

Methods: It is a longitudinal case-control study involving 284 infants born between April and August 2021. Mothers were interviewed at birth and at six months postpartum. At 12 months, the infants' neurodevelopment was assessed using the Bayley III Scale. The explanatory variables were grouped according to NCF components, and their association with Bayley III results was examined using hierarchical logistic regression, adjusting for socioeconomic status and gestational exposure to SARS-CoV-2.

Results: Twenty percent of the sample exhibited delays in at least one Bayley III domain (3% cognitive, 16 % language, and 7 % motor). We found an increased risk of cognitive (OR = 5.78; 95 % CI 1.07-31.09) and motor delays (OR = 6.97; 95 % CI 2.17-22.38) for children who had not undergone regular well-child care in their first six months. The likelihood of a child showing some delay at 12 months was 2.23 times higher when the mother reported concerns about the child's development at six months (95 % CI 1.11-4.50).

Conclusion: Well-child care emerged as a protective factor against cognitive and motor delays, while the mother's concerns were predictive of future developmental issues.