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High rate of insecure attachment patterns in preterm infants at early school age

Katrin Mehler1, Eva Heine1, Angela Kribs1

  • 1Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.

Acta Paediatrica (Oslo, Norway : 1992)
|February 5, 2023
PubMed

Insights

Premature birth increases the risk of insecure attachment in children by early school age. This finding highlights the need for interventions to support attachment security in these vulnerable populations.

Area of Science:

  • Developmental Psychology
  • Neonatal Studies
  • Child Psychiatry

Background:

  • Insecure attachment in preterm infants is linked to later behavioral and emotional issues.
  • Limited data exists on attachment security in preterm children beyond toddlerhood.

Purpose of the Study:

  • To assess attachment security at 6-8 years in very preterm and moderate/late preterm infants.
  • To compare attachment security in preterm children with a full-term control group.

Main Methods:

  • Attachment security was evaluated using the Attachment Story Completion Task in 58 preterm infants (38 very preterm, 20 moderate/late preterm).
  • Attachment patterns of 28 full-term controls were obtained from prior research.
  • Attachment security and scores were primary outcomes; behavioral problems, parental stress, social support, maternal depression, and infant development were secondary outcomes.

Main Results:

  • Very preterm infants exhibited the highest rate of insecure attachment (81%), followed by moderate/late preterm infants (60%) and full-term infants (47%) (p=0.013).
  • Attachment security scores were significantly lower in very preterm infants compared to full-term infants (p=0.001).
  • Secondary outcomes did not significantly differ between the very preterm and moderate/late preterm groups.

Conclusions:

  • Prematurity is associated with a heightened risk of insecure attachment in early school-aged children.
  • Given the prevalence of behavioral problems in preterm populations, interventions promoting attachment security are warranted.
Abstract

Keywords:
attachment securityattachment story completion taskmoderate or late preterm infantsschool agevery preterm infants

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