Testing proximal and distal protective processes in preterm high-risk children

Area of Science:

• Developmental Psychology
• Pediatric Medicine
• Public Health

Background:

• Preterm birth is associated with increased medical risk.
• Early life medical risk can impact long-term child development and competency.
• Protective factors may mitigate risks associated with preterm birth.

Purpose of the Study:

• To examine a model of cumulative medical risk and protective processes in preterm children.
• To assess the impact of these factors on school-age outcomes: cognition, academic achievement, and socioemotional well-being.
• To understand the interplay of risk and protection in high-risk children.

Main Methods:

• Prospective longitudinal study of 151 preterm and 39 full-term infants followed to age 8.
• Construction of indexes for cumulative medical risk, distal protective, and proximal maternal protective processes.
• Hierarchical multiple regression analysis to test effects on competency outcomes.

Main Results:

• Significant main effects of cumulative medical risk and protective processes were found for all competency outcomes.
• Protective processes showed a small to moderate (6%-18%) yet clinically significant effect.
• The study supported hypotheses regarding the influence of risk and protection.

Conclusions:

• A cumulative risk and protection model effectively explains school-age outcomes in preterm children.
• Protective factors play a clinically significant role in moderating the impact of medical risk.
• Understanding the joint occurrence of individual and contextual processes is vital for high-risk children's competence.