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Exceeding expectations after perinatal risks for poor development: associations in term- and preterm-born preschoolers

Journal of Perinatology volume 42, pages 491–498 (2022)Cite this article

Subjects

Abstract

Objective

To define parenting/social characteristics associated with better-than-expected cognitive and motor outcomes in preschoolers at similar perinatal biological risk-level including various gestational ages at birth (GA) and perinatal complications.

Study design

Prospective cohort study (n = 87) of children at four years, median GA 29 weeks (IQR 26, 38). Assessments included Differential Ability Scales, Movement Assessment Battery, parenting styles, and social risk scores. Perinatal risk factors were weighted based on regression models for each outcome; individual calculated risk scores became predictors to extract standardized residuals from the mean (>1 SD above mean = better-than-expected). Mixed-effect regressions examined associations between positive adaptation and parenting/social factors.

Result

Perinatal risk scores explained 21–53% outcome variability. Children across all GA displayed positive adaptation. Children of parents with higher authoritarian scores had higher odds of better-than-expected outcomes (OR 1.17, p = 0.0002).

Conclusion

Parental structure may promote positive adaptation at preschool age in children with perinatal risk factors for poor development, including extreme prematurity.

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Data availability

Non-identifiable data are available on reasonable request five years after study conclusion from the corresponding author.

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Acknowledgements

The authors acknowledge the assistance of project coordinators Kerry Orton and Stephanie Burkhardt and research staff members Lelia Emery, Sandra Glazer, Hanan Guzman, Kaleigh Hague, Brianna Laney, Julia Less, Katelyn Levengood, Megan Lightfoot, Sharon McConnell, Ashley Miller, Gabrielle Moots, Caitlin Kjeldsen, Lindsay Pietruszewski, Jessica Purnell, and Brianna Sowers. We thank Dr. Dennis Lewandowski and Ms. Julieta Harris for their assistance in manuscript preparation. We also thank our families for participating and our colleague at Vanderbilt University, Dr. Sasha Key, for her expertise in ERP paradigm design.

Funding

Support for this study was provided by the Abigail Wexner Research Institute at Nationwide Children’s Hospital.

Author information

Authors and Affiliations

  1. Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA

    Mary Lauren Neel, Kristen Benninger & Lindsay Pietruszewski

  2. Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA

    Mary Lauren Neel, H. Gerry Taylor, Kristen Benninger & Tyler Busch

  3. Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA

    Aryanne de Silva & H. Gerry Taylor

  4. Biostatistics Core, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA

    Emily Hone & Melissa Moore-Clingenpeel

  5. Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, GA, USA

    Nathalie L. Maitre

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Contributions

MLN was responsible for study design, data collection and data analysis, writing the initial and final drafts, and creating the tables. AdS was responsible for study design, data collection, and revising the manuscript. HGT was responsible for study design, data collection, clarified data analysis, and writing and revising the manuscript. KLB was responsible for data analysis, revising tables, and writing and revising the manuscript. TB was responsible for data collection, outcomes analysis, and revising the manuscript. EH was responsible for statistical analysis, tables, and revising the manuscript. MMC was responsible for statistical analysis, tables, and revising the manuscript. LP was responsible for data collection, outcomes analysis, and revising the final version of the manuscript. NLM was responsible for study design, data collection and analysis, creation of tables, writing the initial draft, and revising the manuscript.

Corresponding author

Correspondence to Mary Lauren Neel.

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Neel, M.L., de Silva, A., Taylor, H.G. et al. Exceeding expectations after perinatal risks for poor development: associations in term- and preterm-born preschoolers. J Perinatol 42, 491–498 (2022). https://doi.org/10.1038/s41372-021-01254-9

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