Abstract
During the COVID-19 pandemic, parents in low- and middle-income countries (LMICs) faced greater income loss, high fatality rates, and less accessible healthcare. Peru reported the highest COVID-19 mortality rate globally; yet no known study in Peru has examined the unique impact of COVID-related stressors on parents or their children's behavioral health. Cross-sectional data were drawn from 672 mothers (mean age = 32.5) on COVID-related perceived stress, as part of a longitudinal birth cohort. Factor analyses of COVID-related perceived stress identified three domains which were used in multivariate logistic regression to examine associations with children's (mean age = 7.6; 50.9% boys) internalizing and externalizing symptoms. Mothers reported worries about contracting COVID-19 (86%), losing a job/income (73%), family/friend dying (63.8%), and food intake (60%). Economic insecurity (OR(int) = 1.38 [1.13, 1.68]; OR(ext) = 1.99 [1.55, 2.58]) and physical and mental health worries (OR(int) = 1.77 [1.44, 2.18]; OR(ext) = 1.88 [1.46, 2.44]) were positively associated with children's symptoms. This is one of the few LMIC-based studies that examines the prevalence of COVID-19 perceived stress among mothers and how perceived stress relates to children's behaviors and emotions during the COVID-19 pandemic. Implications are discussed for improving parent-child well-being in LMICs with high rates of COVID-19 disease and death.