Associations Between Paternal Sensitivity and Cognitive and Behavioural Outcomes in Preterm Children: An Individual Participant Data Meta-Analysis.
Noa Gueron-Sela, Karli Treyvaud, Naama Atzaba-Poria and 5 others
In preterm children, more sensitive father–child interaction is linked to higher cognitive scores but not to fewer behaviour problems, and it does not specifically protect the most premature babies.
When mothers' sensitivity is in the same model, the father effect is no longer significant — it looks like a shared family effect.
Key findings
1Paternal sensitivity was positively associated with child cognition (0.25 per SD, 95% CI [0.09, 0.41], p < 0.003) but not with behaviour problems (−0.003, 95% CI [−0.21, 0.20], p = 0.981), after adjusting for child sex, age, multiple birth, SGA, and maternal education.
2The interaction between gestational age and paternal sensitivity was not significant for cognition (p = 0.512) or behaviour (p = 0.537), meaning paternal sensitivity did not specifically buffer the most premature children.
3When maternal sensitivity was added to the same model, neither paternal nor maternal sensitivity showed a unique significant association with child cognition or behaviour (paternal sensitivity on cognition: p = 0.482; maternal sensitivity on cognition: p = 0.063).
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What it does not show
Only two cohorts were pooled, with 84 to 123 families each, which the authors note may limit detection of small effects and interaction effects. The Australian term-born comparison group was small (n = 19), which may have reduced the precision of standardisation and introduced noise into the harmonised scores. Measurement timing differed between cohorts (sensitivity assessed at 6 vs 12 months corrected age; cognition at 12/24 months vs 5 years), which may have affected the pattern of results. There was very little variation in maternal education in both samples, limiting the ability to adjust for this confounder. 8% of the Australian term-born children had neurodevelopmental impairments in infancy, which the authors flag as a possible recruitment bias that could introduce statistical artefacts. The sample comprised relatively low-risk preterm infants, which may have attenuated variability in caregiving responses to prematurity.
Declared interests
The IPD meta-analysis itself did not receive any specific grant from public, commercial, or not-for-profit sectors. Each cohort received its own funding for original data collection. No author conflicts of interest are declared in the supplied text.
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