The impact of moderate or late preterm birth on social understanding

Laverty, Catherine (2022). The impact of moderate or late preterm birth on social understanding. University of Birmingham. Ph.D.

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Abstract

Background: Preterm birth (<37 gestational weeks) accounts for an increasing proportion of global births each year. Moderate or late preterm birth (MLPT) (32+0/7 - 36+6/7 gestational weeks) accounts for over 80% of preterm births yet represents only a fraction of research into prematurity. Whilst outcomes of MLPT were previously considered similar to those of individuals born full-term, more recent evidence suggests this is not the case. Despite the frequency of MLPT, there is a paucity of information surrounding the prevalence of common neurodevelopmental outcomes and association with gestational age. Neonatal follow up is prioritised towards those born at the earliest gestations, with no current guidelines addressing the potential cascading impact of MLPT for children or their parents.

Method: A large scale systematic review and meta-analysis was employed to delineate the prevalence of autism characteristics for individuals born preterm. Two empirical studies to define the prevalence and profile of social abilities within a sample of MLPT children were conducted. These studies combined eye-tracking, behavioural tasks and standardised questionnaires to address these questions in a robust manner. A qualitative interview study was conducted to explore mothers’ perspectives of having a child born MLPT. Healthcare provision, clinical support and educational needs were discussed.

Results: The prevalence of autism characteristics in preterm individuals was estimated at 6-20%, with lower estimates obtained for diagnostic assessments compared to screening tools. Only a small proportion of MLPT children scored above clinical threshold on validated parent report screening measures. Mothers of MLPT born infants highlight the need for further information and support prior to the birth of their child.

Conclusions: Preterm birth is associated with an increased prevalence of social cognitive and neurodevelopmental difficulties, with screening tools an efficient strategy to identify MLPT children for whom further neurodevelopmental assessment may be warranted. Subsequently, service provision and routine additional developmental follow up is encouraged to ensure every child has appropriate and timely support. Future research should actively involve parents and caregivers of MLPT born children as co-researchers to ensure future directions are in line with their priorities.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):