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Social development of children born very preterm: a systematic review
Kirsten Ritchie1, Samudragupta Bora2, Lianne J Woodward2
1Department of Psychology, University of Canterbury, Christchurch, New Zealand.
Insights
Children born very preterm (VPT) often exhibit poorer social competence, including peer problems and social skills deficits, persisting into childhood. Neonatal factors and family socioeconomic status are key predictors.
Area of Science:
- Developmental Psychology
- Pediatric Medicine
- Social Neuroscience
Background:
- Children born very preterm (VPT) (gestation <33 weeks) face unique developmental challenges.
- Social competence is crucial for healthy child development and long-term well-being.
- Understanding predictors of social competence in VPT children is essential for early intervention.
Purpose of the Study:
- To systematically review studies on social competence development in children born VPT.
- To identify neonatal and family predictors associated with social competence in this population.
- To synthesize current evidence on social adjustment, performance, and skills in VPT children.
Main Methods:
- Systematic literature search of PubMed and PsycINFO databases.
- Included studies published after 1990, assessing children aged 0-17 years.
- Utilized PRISMA guidelines for study selection and data extraction.
Main Results:
- Twenty-three studies were included, with overall low methodological quality.
- VPT children demonstrated more peer problems and social withdrawal (16/21 studies).
- Poorer social skills were observed in VPT children; predictors included gestational age, brain abnormalities, and socioeconomic status.
Conclusions:
- Children born VPT exhibit significantly poorer social competence compared to term-born peers.
- These social difficulties are evident early and continue throughout childhood.
- Neonatal and family factors play a critical role in shaping social competence trajectories.
Aim:
To review systematically studies examining the development of social competence in children born very preterm (VPT) (gestation <33 wks) and identify neonatal and family predictors.
Method:
Peer-reviewed original articles were extracted from PubMed and PsycINFO following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Selection criteria included children born VPT and comparison children born at term, sample born after 1990, and children assessed between 0 and 17 years on at least one measure of social competence spanning social adjustment, performance, and/or social skills.
Results:
Twenty-three studies were included. Seven focused on social competence and another 16 examined social competence within a range of outcomes. Study quality was low. Limitations included reliance on single informant data, cross-sectional measurement, use of brief screening tools, absence of child or peer report, and no conceptual model. In terms of social adjustment, 16 out of 21 studies found children born VPT had more peer problems and social withdrawal. Findings of social performance were mixed, with some studies suggesting differences in prosocial behavior (4/14) and others not. Social skills were assessed in four studies and showed children born VPT had poorer skills than children born at term. Predictors of social competence included gestational age, neonatal brain abnormalities, and family socio-economic status.
Interpretation:
Children born VPT have poorer social competence. These difficulties emerge early and persist throughout childhood.
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