Trends in Developmental Delays During a Natural Disaster and Covid-19 Pandemic.

Abstract

Background: In Puerto Rico (PR), statistics of developmental disorders have not been published since 2017 when nearly 3,000 cases were documented. Since the beginning of the COVID-19 pandemic, there’s been a decrease in visits to pediatrician’s office for both preventive and urgent reasons. Moreover, in January 2020, a magnitude 6.4 earthquake devastated part of PR leading to further suspension of pediatrician's office. It is this concern for the loss of surveillance, screening and follow up amid these events and the lack of current statistic in PR, that there is a need to evaluate the prevalence of developmental delays (PDD) in this population. For such we established two objectives: (1) explore the yearly PDD in children admitted to the pediatric unit and (2) identify if there’s been a change in PDD during and after natural disaster and COVID-19 pandemic. Methods: This is a retrospective cross-sectional study. Electronic charts of 1,082 patients, ages 1-60 month, with no previous neurodevelopmental condition and who were admitted to the pediatric unit, during January 2017- December 2021 were reviewed. We obtained their sociodemographic data and the results from the domains of gross motor, fine motor, communication. personal-social and problem solving of the Ages and Stages Questionare-3 (ASQ-3). Results: Of the patients evaluated 56% were male and 44% females, with more than 2/3 of them below the poverty index. The mean age of evaluation was 21.4 month. A steadily increase yearly PDD was noted in all ASQ-3 domains. Statistical analysis showed significance in 3 out of the 5 domains with p-values <0.05. Conclusion: Our study shows steadily increasing PDD in at all areas of development in 2020-2021, correlating with the years of the events. The growing trend is statically significant when compared with previous years, which may be explained by the loss of follow up during this period. To our knowledge, this the only study evaluating how the mentioned events correlate with the normal development of Puerto Rican children. It also provides a recent statistic of patients with some form of developmental delay, suggesting that the current estimate in PR is far lower than the actual PDD.