Moderate prematurity, socioeconomic status, and neurodevelopment in early childhood
Worldwide, 1 in 10 children are born preterm, i.e. before 37 weeks of gestation. The vast majority of these preterm births take place between 32 and 37 weeks (moderate to late preterm). Research has shown that moderate prematurity is associated with higher rates of developmental and behavioural problems. However, this could also be a result of low socioeconomic status (SES) because preterm birth is more common in families with low SES. Moreover, low SES is a risk factor for developmental delay and behavioural and emotional problems. Findings published in this thesis demonstrate that moderate prematurity and low SES separately contribute to developmental delay and behavioural and emotional problems, leading to substantially higher risks if both factors are present. Furthermore, we found that behavioural problems frequently co-occurred with developmental delay. The findings imply that more attention is needed for developmental and behavioural problems in moderately preterm-born children with low SES. Further research is needed to determine in which way early interventions could support preterm children, because it is unknown whether early interventions should mainly focus on stimulating social-emotional and cognitive competencies of the child or for example on improving parent-child interactions. Finally, the thesis includes a discussion on pathways via which moderate prematurity and low SES may lead to neurodevelopmental problems and via which such problems may affect long-term health.