The association between gestation at birth and maternal sensitivity: An individual participant data (IPD) meta-analysis

Background and aim: Studies have documented differences in dyadic sensitivity between mothers of preterm (<37 weeks' gestation) and term born children, but findings are inconsistent and studies often include small and heterogeneous samples. It is not known to what extent variations in maternal sensitivity are associated with preterm birth across the full spectrum of gestational age. Objective: To perform a systematic review and individual participant data (IPD) meta-analysis assessing variations in observed dyadic maternal sensitivity according to child gestational age at birth, while adjusting for known confounders correlated with maternal sensitivity. Method: We harmonised data from 12 birth cohorts from ten countries and carried out one-stage IPD meta-analyses (N = 3951) using mixed effects linear regression. Maternal sensitivity was z-standardised according to the scores of contemporary term-born controls within each respective cohort. All models were adjusted for child sex, age at assessment, neurodevelopmental impairment, small for gestational age birth, and maternal education. Results: The fixed linear effect of the association between gestation at birth and maternal sensitivity across all 12 cohorts was small but stable (0.02 per week [95 % CI = 0.01, 0.02], p < .001). The binary effects of maternal education (0.32 [0.24, 0.40], p < .001) and child neurodevelopmental impairment (-0.33 [-0.50, -0.17], p < .001) were associated with maternal sensitivity. Interpretation: Gestational age at birth is positively associated with dyadic maternal sensitivity, however, the size of the effect is small. Over and above gestation, maternal education and child neurodevelopmental impairment appear to affect sensitivity, highlighting the importance of considering these factors in future research and intervention designs.