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The Association of Maternal Sensitivity with Subsequent Cognition and Language among Children Born Preterm

An Individual Participant Data Meta-analysis

Julia Jaekel, Dieter Wolke, Günter Esser, Lianne J. Woodward, Alicia Spittle, Jeanie Cheong, Anneloes L. van Baar, Marjolein Verhoeven, Noa Gueron-Sela,Naama Atzaba-Poria, Peter J. Anderson, Karli Treyvaud

Objectives To assess variations in children's cognitive and language test scores according to observed dyadic maternal sensitivity and the child's gestational age, after adjustment for known confounders. Study design Systematic review and a one-stage individual participant data meta-analysis of harmonized data from 7 birth cohorts across 5 countries (n = 2560) using mixed effects linear regression. Maternal sensitivity and child cognition and language test scores were z -standardized relative to contemporary cohort-specific term-born controls. Models were adjusted for child sex, multiple birth, small for gestational age, age at outcome assessment, mother's education, mother's age at the child's birth, single mother status, and child neurodevelopmental impairment. Results Maternal sensitivity was associated with subsequently assessed cognition (0.20; 95% CI, 0.14-0.26; P < .001) and language (0.15; 95% CI, 0.08-0.22; P < .001). A significant interaction between gestational age and sensitivity on cognition (−0.01; 95% CI, −0.02 to −0.01; P = .001) was observed; the association between sensitive parenting and later cognition was stronger among children born at younger gestational ages. Sensitivity analyses adjusting for children's neurodevelopment impairments produced similar findings. Conclusions High maternal sensitivity is a potential protective factor for cognitive and language functioning for children born preterm, especially among those born at earlier gestational ages.

Publication language English
Journal Journal of Pediatrics
Volume 293
Publication status Published - 01.06.2026
115024

Keywords

behavior observation
cognition
individual participant data meta-analysis
language
preterm birth
prospective long-term development
sensitive parenting

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

PubMed: MeSH publication types

Journal Article
Meta-Analysis
Systematic Review
Other files and links
Link to publication in Scopus