Parent-child attachment in children born preterm and at term: A multigroup analysis

Abstract

Objective: While ample research exists about mother-child attachment, so far little focus has been on specifics of father-child attachment. Even less research is available on the nature of the father-child relationship for children born preterm. The objective of this study was to determine whether children born preterm (23 to 37 weeks gestation) differ in their attachment to their fathers and mothers from their term peers (> 37 weeks gestation), and whether specific child characteristics, such as gender, twin status, and developmental status, have an influence on the parent-child relationship.

Methods: The sample consisted of 290 children (n = 140 girls, 48.28%), 190 born before term (including 45 twin pairs) between 12 and 36 months of age (M = 19.5, SD = 5.7) and 100 term children of the same age (M = 18.8, SD = 6.1) with their 245 fathers and mothers. Attachment of the children with their mothers and fathers was assessed using the Attachment Q-sort during two home visits. Children's developmental status was measured with the Bayley Scales of Infant and Toddler Development.

Results: Within a multigroup analysis of parents with children born preterm and at term more secure attachment was found for both parents in the term sample than in the preterm group. Correlates of attachment specific to fathers of children born preterm accumulated to an explained variance of R2 = .82. For those fathers, less education as well as lower development scores and male gender of the child were associated with lower attachment scores. In the three other parent-child constellations the explained variance did not exceed 20%. Child development proved to be a significant predictor for father-child attachment regardless of the child's birth status. Male gender was associated with lower attachment scores for children born preterm with either parent.

Conclusion: The findings highlight the importance of including fathers in research and clinical practice and informing them about preterm birth, possible problems, and developmental consequences as well. Health professionals should be advised to create interventions focusing on both parents to enhance the quality of attachment in parent-child dyads in children born preterm.

Fig 1. AQS-score group means of mothers and fathers of children born full-term or preterm.

Fig 2. Multigroup base model of mother-child and father-child attachment in preterm and term children.

Note: the weights of the BSID-III differ only due to standardization.