Social development of children born very preterm: a systematic review.
OBJECTIVE
To review systematically studies examining the development of social competence in children born very preterm (VPT) (gestation <33 wks) and identify neonatal and family predictors.


METHODS
Peer-reviewed original articles were extracted from PubMed and PsycINFO following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Selection criteria included children born VPT and comparison children born at term, sample born after 1990, and children assessed between 0 and 17 years on at least one measure of social competence spanning social adjustment, performance, and/or social skills.


RESULTS
Twenty-three studies were included. Seven focused on social competence and another 16 examined social competence within a range of outcomes. Study quality was low. Limitations included reliance on single informant data, cross-sectional measurement, use of brief screening tools, absence of child or peer report, and no conceptual model. In terms of social adjustment, 16 out of 21 studies found children born VPT had more peer problems and social withdrawal. Findings of social performance were mixed, with some studies suggesting differences in prosocial behavior (4/14) and others not. Social skills were assessed in four studies and showed children born VPT had poorer skills than children born at term. Predictors of social competence included gestational age, neonatal brain abnormalities, and family socio-economic status.


CONCLUSIONS
Children born VPT have poorer social competence. These difficulties emerge early and persist throughout childhood.
Department of Psychology, University of Canterbury, Christchurch, New Zealand.
Kirsten
K
Ritchie
Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Samudragupta
http://orcid.org/0000-0003-2342-4482
S
Bora
Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Lianne J
LJ
Woodward
D000293:Adolescent; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature / Q000523:psychology*; D007231:Infant, Newborn; D012917:Social Adjustment; D066107:Social Skills