Effect of the COVID-19 Pandemic on Children’s Development and Nutritional Status at Age 20 Months in Rural Bangladesh, 2022

The detrimental effects of the COVID-19 pandemic on the learning and mental health among preschool- and school-age children have been demonstrated. However, few studies have examined effects on younger children’s development, though past research suggests this age group is extremely sensitive to economic and health shocks. We assessed the effects of exposure to the pandemic in late gestation and infancy on the cognitive, language, and motor development; behaviour, and growth among toddlers in rural Bangladesh. We compared repeated cross-sectional surveys of children living in the same villages. The first survey included 20-month-old children in 2019 and 2020 (unexposed group). The second survey took place in a random subset of the same villages in 2022 among 20-month-old children, who had experienced pandemic-related lockdowns from approximately mid-gestation through their first year (exposed group). Both surveys used similar inclusion criteria and the same developmental assessments (Bayley’s Scales of Infant and Toddler Development), behaviour observations, and field protocols.
The exposed group had lower cognitive [Effect size=-0.45 (95%CI=-0.63 to -0.27)] and motor [-0.55 (-0.73 to -0.37)] composite scores, compared to the unexposed group. They were also observed to be less responsive to the examiner [-0.29 (-0.48 to -0.11)], less happy [-0.37 (-0.55 to -0.19)], less vocal [-0.57 (-0.73 to -0.4)] and less cooperative [-0.42 (-0.6 to -0.24)]. There was no significant pandemic effect on anthropometry, despite significant reported deficits in food and financial security in exposed compared with unexposed households. The pandemic increased depression among mothers with a primary education or less but not among better educated mothers. Children of less educated mothers also showed larger differences across exposed and unexposed groups in development and behaviour than those with better educated mothers. Disadvantaged young children’s development appears to be extremely vulnerable to shocks Without intervention these deficits may lead to later learning and mental health problems.