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Does Infant Temperament Moderate the Relationship between Very Low Birth Weight and Behavioral Problems Over Six
Lydia Y Li1, Merle Grabener2, Claus Barkmann2
1Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. l.li@uke.de.
Child Psychiatry and Human Development
|November 20, 2025
Summary
Difficult infant temperament did not moderate the link between very low birth weight (VLBW) and internalizing symptoms. However, challenging temperaments were linked to more internalizing problems in all children.
Area of Science:
- Child Psychology
- Developmental Pediatrics
- Behavioral Science
Background:
- Preterm birth and very low birth weight (VLBW) increase the risk of later child psychopathology.
- Longitudinal data on precursors for behavioral issues in VLBW children are limited.
- Understanding factors influencing VLBW children's mental health is crucial.
Purpose of the Study:
- To investigate if difficult infant temperament moderates the association between VLBW and internalizing symptoms.
- To control for family contextual factors like parental depression and socioeconomic status (SES).
- To explore developmental pathways for behavioral problems in VLBW children.
Main Methods:
- Longitudinal HaFEn cohort study in Hamburg, Germany (N=146 families).
- Included 75 VLBW and 71 term-born infants.
- Assessed infant temperament (12 months), internalizing problems (2.0, 4.4, 8.0 years), parental depression, and SES.
Main Results:
- No moderating effect of difficult infant temperament was found on the VLBW-internalizing symptoms link.
- Difficult temperament was significantly associated with higher internalizing problems in both VLBW and term-born groups.
- Parental depressive symptoms and SES were controlled for but did not alter the main findings regarding temperament.
Conclusions:
- Infant temperament is a significant factor associated with internalizing problems, irrespective of birth weight.
- The study underscores the importance of considering temperamental predispositions in child behavioral development.
- Further research is needed on factors like parenting and SES influencing VLBW children's mental health outcomes.
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