Objectives To examine if gestational age groups predict the development of social competence difficulties (SCDs) from childhood into mid-adolescence and to assess the mediation by maternal psychological distress during infancy on these trajectories.
Design Nationally representative population-based birth cohort (UK Millennium Cohort Study).
Participants 15 821 children born in 2000–2002.
Outcome measures SCDs (derived from peer and prosocial subscales of Strengths and Difficulties Questionnaire) were assessed by parent report when the participants were aged 3, 5, 7, 11 and 14 years. Maternal psychological distress was self-rated using Rutter Malaise Inventory when the children were 9 months of age. Data were modelled using latent growth curve analysis.
Results Developmental trajectories of SCDs were U-shaped in all groups. Very preterm (VP) children (<32 weeks, n=173) showed pronounced difficulties throughout, with the coefficient difference from the full term at age 14 being 0.94 (95% CI 0.23 to 1.66, equivalent to 0.32 SD of the population average SCDs). Moderate-to-late preterm children (32–36 weeks, n=1130) and early-term children (37–38 weeks, n=3232) showed greater difficulties compared with the full-term peers around age 7 years, which resolved by age 14 years (b=0.20, 95% CI –0.05 to 0.44; b=0.03, 95% CI –0.12 to 0.17, respectively). Maternal psychological distress during infancy mediated 20% of the aforementioned association at age 14 years for the VP.
Conclusion There was a dose–response association between gestational age and the trajectories of SCDs. Monitoring and providing support on social development throughout childhood and adolescence and treating early maternal psychological distress may help children who were born earlier than ideal, particularly those born VP.
- child psychiatry
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Correction notice This paper has been updated since it was published online. The authors' affiliations have been reordered.
Contributors MH designed the study, carried out the analysis and drafted the initial manuscript. NC, YK and AS provided support on the design of the study and interpretation of the results and revised the manuscript.
Funding This work was supported by the UK Economic and Social Research Council (ES/R008930/1) and the Japan Foundation for Paediatric Research.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The data collection of Millennium Cohort Study (MCS) is approved by the UK National Health Service Research Ethics Committee and written consent was obtained from all participating parents at each survey; MCS1: South West MREC (MREC/01/6/19); MCS2 and MCS3: London MREC (MREC/03/2/022, 05/MRE02/46); MCS4: Yorkshire MREC (07/MRE03/32); MCS5: Yorkshire and The Humber-Leeds East (11/YH/0203); MCS6: London MREC(13/LO/1786). The use of anonymised data for academic purposes did not require additional ethical approval.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available in a public, open access repository. Millennium Cohort Study is available via the UK Data Archive. Further information about the study is found at https://cls.ucl.ac.uk/cls-studies/millennium-cohort-study/.
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