Page 79 - Sample Moderate prematurity, socioeconomic status, and neurodevelopment in early childhood

preterm birth and neurodevelopmental problems. In addition, we found that those children with low family SES were characterized by certain features such as being part of a single-parent family, having a mother younger than 25 years, and having a mother of non-European ethnicity. This fits with the current PCH guidelines that identify these features as risk factors for psychosocial problems.87, 89
Second, co-occurrence of developmental and behavioural problems needs more attention in MP children. PCH professionals should be aware of the high probability of co-occurring behavioural and emotional problems if MP children have delays in one or more developmental domains. In particular, the combination of developmental delay with externalizing problems occurred frequently in MP children. Early identification of co-occurring developmental and behavioural problems is important because it predicts psychosocial problems at school age and beyond.90-92
Implications for further research
The findings presented in this thesis provide more insight into the pathways via which moderate prematurity and low SES lead to neurodevelopmental problems and via which emotion regulation may promote long-term health. Further research is needed to reveal the clinical implications of these findings.
Disentangling the pathways leading to neurodevelopmental problems
We proposed three pathways via which moderate prematurity and low SES may lead to neurodevelopmental problems: 1) prenatal influences, 2) parental well- being and parental involvement in the pre-school years, and 3) the disruptive effects of moderate prematurity and low SES on brain development. As we describe below, each of these pathways leads to ideas for further research.
1) Prenatal influences
Poorer mental and physical health during pregnancy increases the risk of 7 mortality and morbidity in newborns. We proposed that antenatal maternal stress
may initiate mechanisms leading to neurodevelopmental problems in preterm
and low SES children due to the associations of antenatal maternal stress with
all of these factors.5, 7 A better understanding of these mechanisms may offer new possibilities for the prevention of preterm birth and neurodevelopmental problems. One suggestion is to investigate which part of the association between antenatal maternal stress and neurodevelopmental problems is through preterm
General discussion
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