Associations Between Paternal Sensitivity and Cognitive and Behavioural Outcomes in Preterm Children: An Individual Participant Data Meta-Analysis.

BACKGROUND

Children born preterm (PT) face elevated neurodevelopmental risk, yet the role of fathers' sensitive caregiving in this process remains understudied.

OBJECTIVE

To test whether observed paternal sensitivity predicts cognitive and behavioural outcomes in PT children and moderates prematurity-related risk.

METHODS

Individual participant data (IPD) from two prospective cohorts in Australia and Israel (2009-2014) were pooled (N = 207; 151 PT, 56 term). Father-child and mother-child dyadic interactions at 6-12 months corrected age were observed and coded with the emotional availability (EA) sensitivity scale. Child cognition and behaviour were assessed at 5 years of age. Mixed-effects regressions controlled for sex, age, multiple birth, small-for-gestational-age status and maternal education.

RESULTS

Higher paternal sensitivity predicted higher cognitive scores (β = 0.25 per SD, 95% confidence interval = [0.09, 0.41], p < 0.003). Paternal sensitivity was not related to children's later behavioural problems (-0.003 [-0.21, 0.20], p = 0.981). No gestational age × paternal sensitivity interaction emerged.

CONCLUSIONS

Sensitive fathering confers an additive, clinically meaningful benefit for cognitive function in both PT and term children, over and above social and medical risk. Early-intervention programs that actively engage fathers and support sensitive responsive interactions may enhance developmental trajectories in this vulnerable population.