Associations Between Paternal Sensitivity and Cognitive and Behavioural Outcomes in Preterm Children: An Individual Participant Data Meta-Analysis
Abstract
Background: Children born preterm (PT) face elevated neurodevelopmental risk, yet the role of fathers' sensitive caregiving in this process remains understudied.
Objective: To test whether observed paternal sensitivity predicts cognitive and behavioural outcomes in PT children and moderates prematurity-related risk.
Methods: Individual participant data (IPD) from two prospective cohorts in Australia and Israel (2009-2014) were pooled (N = 207; 151 PT, 56 term). Father-child and mother-child dyadic interactions at 6-12 months corrected age were observed and coded with the emotional availability (EA) sensitivity scale. Child cognition and behaviour were assessed at 5 years of age. Mixed-effects regressions controlled for sex, age, multiple birth, small-for-gestational-age status and maternal education.
Results: Higher paternal sensitivity predicted higher cognitive scores (β = 0.25 per SD, 95% confidence interval = [0.09, 0.41], p < 0.003). Paternal sensitivity was not related to children's later behavioural problems (-0.003 [-0.21, 0.20], p = 0.981). No gestational age × paternal sensitivity interaction emerged.
Conclusions: Sensitive fathering confers an additive, clinically meaningful benefit for cognitive function in both PT and term children, over and above social and medical risk. Early-intervention programs that actively engage fathers and support sensitive responsive interactions may enhance developmental trajectories in this vulnerable population.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 207 participants or records.
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