Researchers at University of Warwick have identified modifiable social factors that help preterm children develop better-than-expected mental health, offering new hope for a persistent problem.
Around 8% of all births in England are preterm. Despite improvements in neonatal care and survival, preterm children still have more difficulties in later life than their peers, including a higher risk of mental health problems, which have not improved in recent decades.
Published today in The Journal of Child Psychology and Psychiatry, this major study has taken a new direction, adopting a broader-view by looking at social factors that can help preterm-born children succeed even after they've left the hospital.
By analysing data from over 1,500 children born preterm from the Bavarian Longitudinal Study (Germany) and the UK Millennium Cohort Study, researchers have identified seven family and social factors that were linked to better mental health outcomes for children born preterm.
"Roughly half of preterm-born children go on to have positive mental health outcomes, while others face difficulties" said Dr Sabrina Twilhaar, Assistant Professor, Department of Psychology at Warwick and lead author of the study. "Finding these factors that predict positive outcomes emphasises that mental health resilience isn't just down to luck … it's partly shaped by the environments that children grow up in, and we now have a clearer idea of where to put our focus to help more children thrive."
The researchers found that better self-regulation, strong relationships with parents - especially mothers - supportive family environments, and protection from bullying were all linked to improved mental health outcomes in preterm children.
This is the first study to take such a comprehensive look at modifiable factors that promote mental health resilience in this group, identifying not only what puts children at risk, but also what helps them thrive. It shows that, while medical interventions are crucial, they are not the only path to improving outcomes for vulnerable groups.
"What's striking is that these are all things we can alter with interventions," said Professor Dieter Wolke, Department of Psychology, University of Warwick, co-author of the study. "Supporting parenting, improving interparental relationships, and tackling bullying could make a real difference for the mental health of preterm-born children."
This research presents a roadmap for programmes aiming to improve outcomes after preterm birth. It urges for follow-up care that starts in the hospital but then continues after discharge - that supports not just the child, but their whole family system.
