Impacto da pandemia de COVID-19 no desenvolvimento motor de crianças aos 36 meses de idade

Abstract

Introduction: Motor development is one of the main indicators of child health and can be influenced by biological, social, and environmental factors. The COVID-19 pandemic and gestational exposure to the SARS-CoV-2 virus may have affected neurodevelopment, especially in children born during this period. Objective: To evaluate the influence of gestational exposure to SARS-CoV-2 and the COVID-19 pandemic on motor development of children at 36 months of age. Materials and Methods: This was a cross-sectional study nested within a cohort initiated in 2021, with a non-probabilistic sample. Data collection took place between May and September 2024 in Uberlândia, Minas Gerais, Brazil. The initial cohort recruited postpartum women and neonates in five municipalities in the state of Minas Gerais starting in April 2021, with blood samples collected on filter paper to detect anti–SARS-CoV-2 IgG in the mother–child dyad. Newborns were considered exposed to the virus if they had positive serology, if their mothers had positive serology, or if their mothers had a positive RT-PCR result during pregnancy. Children aged 36 months who participated in the initial recruitment were included. Initially, a telephone-administered questionnaire was applied to assess economic classification, child routine, and family risk factors; clinical and anthropometric variables were recorded in person on the day of assessment. Motor development was evaluated using the Movement Assessment Battery for Children–2 (MABC-2), and children were classified into three motor performance zones: red (significant motor difficulty), amber (mild/moderate motor difficulty), and green (no motor difficulties). Analyses included descriptive statistics, bivariate tests, and multinomial classification regression. Results: The sample consisted of 57 children, of whom 30 (53%) were exposed to SARS-CoV-2 during pregnancy. In the multinomial regression analysis, gestational exposure to the virus (OR = 0.048; 95% CI 0.004–0.65; p = 0.023) and the child’s Body Mass Index (BMI) (OR = 0.23; 95% CI 0.07–0.75; p = 0.015) showed a significant association with MABC-2 classification. Non-exposed children and those with higher BMI had a lower probability of being at risk for motor difficulties compared with those without motor difficulties. Conclusion: Gestational exposure to SARS-CoV-2 was associated with a higher risk of motor difficulties at 36 months, whereas higher BMI was associated with a lower probability of motor difficulties. These findings reinforce the importance of continuous monitoring of children born during the COVID-19 pandemic to enable early identification of motor delays and timely implementation of physiotherapeutic intervention strategies.