Peer Relationship Outcomes of School-Age Children Born Very Preterm

J Pediatr. 2018 Oct;201:238-244. doi: 10.1016/j.jpeds.2018.05.034. Epub 2018 Jun 27.


Objectives: To characterize the friendship networks, peer relationships, and bullying experiences of 12-year-old children born extremely preterm (EPT; 23-27 weeks of gestation), very preterm (VPT; 28-32 weeks of gestation), and full term (FT; 38-41 weeks of gestation), and to identify child characteristics placing children at risk of peer problems.

Study design: A regional cohort of 44 EPT, 60 VPT, and 109 FT born children were followed prospectively to 12 years of age. The nature of children's close friendships, peer relations, and bullying experiences were assessed using a multimethod approach, including parent, teacher, and child report.

Results: Across all measures, children born EPT had more peer social difficulties than children born VPT and FT. They were more likely to report no close friendships (5%-14% EPT vs 0%-3% VPT/FT), dissatisfaction with their peer network (16% vs 1%-2%), and less time interacting face-to-face with friends (16%-23% vs 5%-8%). They were also 3 times more likely to be rated by their parents and teachers as experiencing problems relating to peers (P ≤ .001). In contrast, rates of chronic bullying (≥2 times/week) were similar for EPT and VPT children (12%-14% vs 4% FT). Emotional problems, inattention/hyperactivity, and motor deficits were associated with an increased risk of peer relationship problems, whereas higher body mass index, delayed pubertal development, vision problems, and inattention/hyperactivity problems were associated with frequent bullying.

Conclusions: With the exception of bullying, risks of peer social difficulties were greatest among children born EPT. Peer social relationships should be monitored as part of longer term developmental surveillance and support.

Keywords: bullying; follow-up; friendship; low birthweight; outcome; peer; preterm.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Child Behavior Disorders / epidemiology*
  • Child Behavior Disorders / psychology
  • Child, Preschool
  • Emotions / physiology*
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Infant
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Infant, Premature, Diseases / epidemiology*
  • Infant, Premature, Diseases / psychology
  • Interpersonal Relations
  • Male
  • Parents / psychology
  • Prospective Studies