Maternal parenting skills, adverse clinical outcomes, and contextual factors in low-income families: Associations and predictors of the neurodevelopment of preterm children in the first two years of life.

Background: Preterm children are a risk group for neurodevelopmental delays, while interactions with their mothers may serve as a protective factor.

Aims: The objectives of this study were to (1) identify changes in preterm children's neurodevelopment, maternal skills, and mother-child interactions of preterm children from the first to the second year of life; (2) analyze differences between preterm children with and without developmental delays in relation to social skills, parenting skills, and mother-child interaction; and (3) examine the risk and protective factors associated with the neurodevelopment of preterm children.

Methods: Participants included 47 Brazilian preterm children and their mothers, assessed at the first (Mage/months = 10.4, SD =3.6) and second (Mage/months= 26.2, SD=8.5) years of life, using corrected age. The Bayley Scale of Infants and Toddler Development -III and the Interaction Rating Scale were used for assessment.

Results: Cognitive and language scores decreased from the first to the second year of life, while children's motor and social skills, parenting skills, and mother-child interactions remained stable. In the second year of life, neurodevelopmental delays were associated with lower social skills, reduced parenting skills, and less evident mother-child interactions. Significant factors influencing child neurodevelopment in the first year of life included the number of children at home, NICU stays, maternal age, and parenting practices that foster cognitive growth. In the second year, neurodevelopment was primarily influenced by mother-child interactions and breastfeeding. Additionally, the number of children at home, child autonomy, responsiveness to the mother, breastfeeding, and family income were predictors of neurodevelopment in the second year.

Conclusion: The results underscore the importance of enhancing mother-child interactions and parenting skills to promote neurodevelopment in premature children. The findings provide valuable insights for intervention programs targeting social skills, aimed at fostering positive peer interactions and facilitating social integration among children with developmental challenges.