Publication date: Jun 27, 2025

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 = 1. 38 [1. 13, 1. 68]; OR = 1. 99 [1. 55, 2. 58]) and physical and mental health worries (OR = 1. 77 [1. 44, 2. 18]; OR = 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.

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