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Peer Relationship Outcomes of School-Age Children Born Very Preterm
Kirsten Ritchie1, Samudragupta Bora2, Lianne J Woodward3
1Department of Psychology, University of Canterbury, Christchurch, New Zealand.
Insights
Children born extremely preterm face greater peer social difficulties, including fewer friendships and more relationship problems. Bullying rates were similar for extremely and very preterm children, but social challenges require ongoing monitoring.
Area of Science:
- Developmental Psychology
- Neonatal Medicine
- Pediatric Social Health
Background:
- Extremely preterm (EPT) birth (23-27 weeks gestation) and very preterm (VPT) birth (28-32 weeks gestation) are associated with significant neurodevelopmental challenges.
- Peer relationships and social integration are critical developmental milestones for school-aged children.
- Understanding social difficulties in EPT and VPT populations is crucial for targeted interventions.
Purpose of the Study:
- To characterize friendship networks, peer relationships, and bullying experiences in 12-year-old children born EPT, VPT, and full-term (FT).
- To identify child-specific characteristics that increase the risk of peer problems in preterm populations.
Main Methods:
- Prospective cohort study of 44 EPT, 60 VPT, and 109 FT children followed to age 12.
- Multimethod assessment including parent, teacher, and child self-report on friendships, peer relations, and bullying.
- Statistical analysis to compare groups and identify risk factors.
Main Results:
- Children born EPT exhibited significantly more peer social difficulties than VPT and FT peers.
- EPT children were more likely to report no close friendships, peer network dissatisfaction, and less face-to-face interaction.
- While chronic bullying rates were similar between EPT and VPT children, EPT children were three times more likely to experience peer relationship problems.
Conclusions:
- Preterm birth, particularly extreme prematurity, poses a substantial risk for peer social difficulties, excluding bullying.
- Emotional problems, inattention, hyperactivity, and motor deficits are linked to peer relationship issues.
- Monitoring peer social relationships is essential for long-term developmental surveillance and support for EPT children.
Objectives:
To characterize the friendship networks, peer relationships, and bullying experiences of 12-year-old children born extremely preterm (EPT; 23-27 weeks of gestation), very preterm (VPT; 28-32 weeks of gestation), and full term (FT; 38-41 weeks of gestation), and to identify child characteristics placing children at risk of peer problems.
Study Design:
A regional cohort of 44 EPT, 60 VPT, and 109 FT born children were followed prospectively to 12 years of age. The nature of children's close friendships, peer relations, and bullying experiences were assessed using a multimethod approach, including parent, teacher, and child report.
Results:
Across all measures, children born EPT had more peer social difficulties than children born VPT and FT. They were more likely to report no close friendships (5%-14% EPT vs 0%-3% VPT/FT), dissatisfaction with their peer network (16% vs 1%-2%), and less time interacting face-to-face with friends (16%-23% vs 5%-8%). They were also 3 times more likely to be rated by their parents and teachers as experiencing problems relating to peers (P ≤ .001). In contrast, rates of chronic bullying (≥2 times/week) were similar for EPT and VPT children (12%-14% vs 4% FT). Emotional problems, inattention/hyperactivity, and motor deficits were associated with an increased risk of peer relationship problems, whereas higher body mass index, delayed pubertal development, vision problems, and inattention/hyperactivity problems were associated with frequent bullying.
Conclusions:
With the exception of bullying, risks of peer social difficulties were greatest among children born EPT. Peer social relationships should be monitored as part of longer term developmental surveillance and support.
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