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Gestational age on trajectories of social competence difficulties into adolescence
Mariko Hosozawa1,2, Noriko Cable3, Yvonne Kelly3
1Institute for Global Health Policy Research, Bureau of International Health, National Center for Global Health and Medicine, Tokyo, Japan mhosozawa@it.ncgm.go.jp.
Insights
Children born very preterm experience social competence difficulties throughout adolescence. Maternal distress in infancy partially explains these challenges, highlighting the need for early support.
Area of Science:
- Developmental psychology
- Perinatal health
- Social-emotional development
Background:
- Gestational age is a critical factor influencing child development.
- Social competence difficulties (SCDs) can emerge in childhood and persist into adolescence.
- Maternal psychological distress during infancy may impact child social development trajectories.
Purpose of the Study:
- To investigate if gestational age groups predict the development of social competence difficulties (SCDs) from childhood to mid-adolescence.
- To assess the mediating role of maternal psychological distress in infancy on these developmental trajectories.
Main Methods:
- Utilized data from a nationally representative UK Millennium Cohort Study (n=15,821).
- Assessed SCDs via parent-report (Strengths and Difficulties Questionnaire) at ages 3, 5, 7, 11, and 14 years.
- Measured maternal psychological distress using the Rutter Malaise Inventory at 9 months postpartum; analyzed using latent growth curve modeling.
Main Results:
- Developmental trajectories of SCDs were U-shaped across all gestational age groups.
- Very preterm (VP) children (<32 weeks) exhibited persistent and pronounced social difficulties into mid-adolescence.
- Moderate-to-late preterm and early-term children showed transient difficulties around age 7, resolving by age 14. Maternal psychological distress mediated 20% of the association between VP birth and SCDs at age 14.
Conclusions:
- A dose-response relationship exists between gestational age and the developmental trajectories of SCDs.
- Early and ongoing support for social development is crucial for children born prematurely, especially those born very preterm.
- Addressing maternal psychological distress in infancy is a key intervention point to mitigate social difficulties in early-born children.
Objectives:
To examine if gestational age groups predict the development of social competence difficulties (SCDs) from childhood into mid-adolescence and to assess the mediation by maternal psychological distress during infancy on these trajectories.
Design:
Nationally representative population-based birth cohort (UK Millennium Cohort Study).
Participants:
15 821 children born in 2000-2002.
Outcome Measures:
SCDs (derived from peer and prosocial subscales of Strengths and Difficulties Questionnaire) were assessed by parent report when the participants were aged 3, 5, 7, 11 and 14 years. Maternal psychological distress was self-rated using Rutter Malaise Inventory when the children were 9 months of age. Data were modelled using latent growth curve analysis.
Results:
Developmental trajectories of SCDs were U-shaped in all groups. Very preterm (VP) children (<32 weeks, n=173) showed pronounced difficulties throughout, with the coefficient difference from the full term at age 14 being 0.94 (95% CI 0.23 to 1.66, equivalent to 0.32 SD of the population average SCDs). Moderate-to-late preterm children (32-36 weeks, n=1130) and early-term children (37-38 weeks, n=3232) showed greater difficulties compared with the full-term peers around age 7 years, which resolved by age 14 years (b=0.20, 95% CI -0.05 to 0.44; b=0.03, 95% CI -0.12 to 0.17, respectively). Maternal psychological distress during infancy mediated 20% of the aforementioned association at age 14 years for the VP.
Conclusion:
There was a dose-response association between gestational age and the trajectories of SCDs. Monitoring and providing support on social development throughout childhood and adolescence and treating early maternal psychological distress may help children who were born earlier than ideal, particularly those born VP.
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