Parenting style impacts cognitive and behavioural outcomes of former preterm infants: A systematic review

Abstract

We sought to evaluate published evidence in aggregate regarding the impact of parenting style on the cognitive and behavioural outcomes of former preterm infants. We searched 5 databases using germane MeSH terms. Parenting style was defined as any descriptor of parenting using ≥2 dimensions on published parenting axes. We evaluated studies for quality of evidence and strength of recommendations using standardized tools and categorized summative recommendations by parenting axis and child outcome. Twenty-seven articles met our inclusion criteria. Parental responsivity is the only parenting axis strongly associated with both improved child cognition and behaviour. Parental demandingness is associated only with improved child cognition, and parental warmth and rejection are associated only with child behaviour. Parental coercion is not associated with subsequent child outcomes. Parental responsivity may be essential in optimizing neurodevelopment in former preterm infants. More targeted studies are needed to inform this relationship and identify opportunities for intervention.

Keywords: development; parent; preterm.

Figure 1

Figure 1 legend: This figure depicts the eight axes seen in the literature that comprise parenting style (Baumrind 1967, Maccoby & Martin 1983, Skinner et al 2005).

Figure 2

Figure 2a & 2b legend: This figure represents the quantity and quality of the evidence relating parenting axes with either child cognitive (2a) or behavioral (2b) outcomes. Parenting style axes are defined as follows: Warmth – positive affect and acceptance of child Rejection – hostility or criticism towards child Demandingness – degree of developmentally appropriate expectations Structure – assertive control and consistency Responsivity – sensitivity to child’s cues Autonomy support – nondirective support and respect for child’s independence Coercion – intrusiveness or over controlling >0 (+ direction) indicates a positive association, 0 no association, and <0 (− direction) a negative association between the parenting axis and child outcome. The size of the circle represents the number of studies. The color of the circle indicates the strength of recommendation, with dark gray indicating strong recommendations in positive and negative directions, respectively. Light gray indicates a conditional recommendation. Axes for which recommendations could not be made were excluded from these figures.

Figure 2

Figure 2a & 2b legend: This figure represents the quantity and quality of the evidence relating parenting axes with either child cognitive (2a) or behavioral (2b) outcomes. Parenting style axes are defined as follows: Warmth – positive affect and acceptance of child Rejection – hostility or criticism towards child Demandingness – degree of developmentally appropriate expectations Structure – assertive control and consistency Responsivity – sensitivity to child’s cues Autonomy support – nondirective support and respect for child’s independence Coercion – intrusiveness or over controlling >0 (+ direction) indicates a positive association, 0 no association, and <0 (− direction) a negative association between the parenting axis and child outcome. The size of the circle represents the number of studies. The color of the circle indicates the strength of recommendation, with dark gray indicating strong recommendations in positive and negative directions, respectively. Light gray indicates a conditional recommendation. Axes for which recommendations could not be made were excluded from these figures.