Covid-19 Pandemic and Psychomotor Development in Chilean Infants and Preschoolers: A Cohort-Based Analysis of Age and Socioeconomic Disparities

Background: Early childhood is a critical period for brain development, where neural circuits mature rapidly. The COVID-19 pandemic introduced stressors, including social isolation and reduced learning opportunities, potentially impacting psychomotor development. This study examines its effects on Chilean infants (0–24 months) and preschoolers (25–60 months), focusing on socioeconomic disparities. Methods: A retrospective cohort study was conducted using electronic health records from a primary care center in Santiago, Chile. Psychomotor development was assessed using the Escala de Evaluación del Desarrollo Psicomotor (EEDP) for infants and the Test de Evaluación del Desarrollo Psicomotor (TEPSI) for preschoolers. Logistic regression models examined the association between pandemic exposure and psychomotor delay, adjusting for socioeconomic level, sex, and age. Results: Psychomotor delay increased in both age groups during the pandemic (infants: OR = 1.73, 95 % CI: 1.167–2.552; preschoolers: OR = 2.05, 95 % CI: 1.138–3.685). Among infants, the effect was observed across all socioeconomic levels, though higher-income groups had a lower risk. A significant interaction between pandemic exposure and socioeconomic status was found (p < 0.05). In preschoolers, delay increased in low- to upper-middle-income groups, while high-income children were unaffected. No significant interaction was observed. Sex was not a significant modifier. Conclusion: The COVID-19 pandemic increased psychomotor delays, particularly in lower-income preschoolers. Socioeconomic status moderated the effect in infants but not preschoolers, suggesting age-dependent vulnerability. The absence of sex-related differences suggests that environmental factors, such as reduced social and learning opportunities, played a major role. Targeted interventions are needed to mitigate long-term inequalities. © 2025 Elsevier Ltd