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Background: In Germany, more than 40% of infants are born to immigrant parents. Increased survival rates of very preterm (below 32 weeks gestation at birth; VP) infants have not resulted in equally improved life chances and quality of life. More information on perinatal variations in outcomes according to social inequalities, migration background, and language barriers is needed. We tested whether mothers' immigrant status and language barriers are associated with perinatal health and short-term neonatal outcomes. Methods: The data are from the national multi-centre German Neonatal Network (GNN) cohort, including VP births from 2009 onwards. In total, 3606 (n = 1738 female) children were assessed, and 919 (n = 449 female) of these children had immigrant backgrounds. Immigrant status was operationalised as a binary variable based on the children's mothers' countries of birth (born in Germany vs. foreign-born). Self-reported home language (L1) was used to calculate the average linguistic distance to German as one continuous variable. Results: Mixed-effects models showed that two out of fourteen effects of interest survived the adjustment for known confounders and accounting for the nestedness of data within birth hospitals. Linguistic distance from mothers' L1s to German was independently associated with diagnoses of preeclampsia (OR = 1.01, 95% CI = [1.00, 1.01]). Infants of foreign-born mothers had higher odds for amniotic infection syndrome (AIS; OR = 1.45 [1.13, 1.86]) than infants of German mothers. Conclusions: Our findings from this large multi-centre longitudinal cohort of VP-born children indicate that maternal immigrant status and language barriers have limited impact on perinatal health and severe neonatal outcomes. This suggests that, regardless of background or language skills, there may be few inequalities in the perinatal health of pregnant women and their newborn preterm infants. [ABSTRACT FROM AUTHOR]

BackgroundDifferential Susceptibility Theory (DST) postulates that some children are more affected - for better and for worse - by developmental experiences, including parenting, than others. Low birth weight (LBW, 1,500-2,499 g) may not only be a predictor for neurodevelopmental impairment but also a marker for prenatally programmed susceptibility. The aim was to test if effects of sensitive parenting on LBW and very LBW (VLBW,

Objectives: Retrospective harmonisation of data obtained through different instruments creates measurement error, even if the underlying concepts are assumed the same. We tested a novel method for item‐level data harmonisation of two widely used instruments that measure emotional and behavioural problems: the Child Behavior Checklist (CBCL) and the Strengths and Difficulties Questionnaire (SDQ). Methods: Item content of the CBCL and SDQ was mapped onto four dimensions: emotional problems, peer relationship problems, hyperactivity/inattention and conduct problems. A diverse test sample was drawn from four prospective longitudinal birth cohort studies in Australia and Europe who used one or both instruments. The pooled sample included 5188 data points assessing children and adolescents aged 6–13 years (N = 257–704 participants per cohort). Measurement invariance was assessed using latent variable multi‐group confirmatory factor analysis. Results: Fifteen items from the CBCL and SDQ were mapped onto four dimensions allowing for measurement invariance testing as part of a stepwise process. Partial strict invariance between CBCL and SDQ assessments was established for all four dimensions. Conclusions: The harmonised dimensions of emotional, peer relationship, hyperactivity/inattention and conduct problems are invariant across the CBCL and SDQ suggesting that these dimensions can be reliably compared with limited measurement error. [ABSTRACT FROM AUTHOR]

Background: Very preterm (VP; gestational age <32 weeks) and very low birth weight (VLBW; <1500 grams) is related to attention problems in childhood and adulthood. The stability of these problems into adulthood is not known. Methods: The Bavarian Longitudinal Study is a prospective cohort study that followed 260 VP/VLBW and 229 term-born individuals from birth to adulthood. Data on attention were collected at 6, 8, and 26 years of age, using parent reports, expert behavior observations, and clinical ADHD diagnoses. Results: At each assessment, VP/VLBW individuals had significantly more attention problems, shorter attention span, and were more frequently diagnosed with ADHD than term-born comparisons. In both VP/VLBW and term-born individuals, overall, attention span increased and attention problems decreased from childhood to adulthood. Attention problems and attention span were more stable over time for VP/VLBW than term-born individuals. Similarly, ADHD diagnoses showed moderate stability from childhood to adulthood in VP/VLBW, but not in term-born individuals. However, when those with severe disabilities were excluded, differences between VP/VLBW and term-born individuals reduced. Conclusions: Despite improvement in attention regulation from childhood to adulthood, children born very preterm remained at increased risk for attention problems in adulthood. In contrast, term-born children with clinical attention problems outgrew these by adulthood. As inattentive behavior of VP/VLBW children may be overlooked by teachers, it may be necessary to raise awareness for school intervention programs that reduce attention problems in VP/VLBW children.

Background: Children born very preterm (VP <32 weeks gestation) and/or with very low birth weight (VBLW <1500 g; subsequently VP/VLBW) have been previously reported to have more cognitive impairment and specific executive functioning problems than term children; however, it remains unclear whether these problems persist into adulthood. This study aimed to examine general intelligence (IQ) and executive functioning (EF) of adults born VP/VLBW in comparison to term controls. Additionally, the effects of smallness for gestational age (SGA) and family socioeconomic status (SES) at birth were investigated. Methods: The Bavarian Longitudinal Study is a geographically defined prospective cohort study of neonatal at-risk children born in 1985/86 in Southern Germany. A total of 217 VP/VLBW and 197 controls completed the battery of IQ and EF tests at 26 years of age. Results: VP/VLBW adults scored significantly lower than controls in IQ and EF. There was a 1.16 standard deviation (SD) unit difference between the VP/VLBW and controls in Full-Scale IQ. VP/VLBW adults were found to have general and multiple cognitive problems rather than specific deficits in EF. SGA was not a significant predictor of cognitive impairment. Family SES had a significant impact on general intelligence in both VP/VLBW and term controls. The SES effects amounted to 1.13 SD units between individuals born into high versus low SES. Conclusions: No narrowing of cognitive deficits between VP/VLBW and term control adults to previous childhood assessments at 6 years of age was found. VP/VLBW adults do not outgrow their cognitive problems despite many receiving special educational support in childhood. Low family SES at birth has similar additive adverse effects on cognitive performance in VP/VLBW and term offspring.

Background: Differential Susceptibility Theory (DST) postulates that some children are more affected--for better and for worse--by developmental experiences, including parenting, than others. Low birth weight (LBW, 1,500-2,499 g) may not only be a predictor for neurodevelopmental impairment but also a marker for prenatally programmed susceptibility. The aim was to test if effects of sensitive parenting on LBW and very LBW (VLBW, <1,500 g) versus normal birth weight (NBW, =2,500 g) children's academic achievement are best explained by a differential susceptibility versus diathesis-stress model of person-X-environment interaction. Methods: Nine hundred and twenty-two children ranging from 600 g to 5,140 g birth weight were studied as part of a prospective, geographically defined, longitudinal investigation of neonatal at-risk children in South Germany (Bavarian Longitudinal Study). Sensitive parenting during a structured mother-child interaction task was observed and rated at age 6 years. Academic achievement was assessed with standardized mathematic, reading, and spelling/writing tests at age 8 years. Results: Maternal sensitivity positively predicted the academic achievement of both LBW (n = 283) and VLBW (n = 202) children. Confirmatory-comparative and model-fitting analysis (testing LBW vs. NBW and VLBW vs. NBW) indicated that LBW and VLBW children were more susceptible than NBW to the adverse effects of low-sensitive, but not beneficial effects of high-sensitive parenting. Conclusions: Findings proved more consistent with the diathesis stress than differential-susceptibility model of person-X-environment interaction: LBW and VLBW children's exposure to positive parenting predicted catch-up to their NBW peers, whereas exposure to negative parenting predicted much poorer functioning.

Aim: Mothers of very preterm children have been reported to behave less sensitively and to be more controlling. It is unknown whether this is the result of maternal factors or due to maternal adaptation to children's cognitive problems. Method: We investigated a geographically defined prospective whole-population sample of very low birthweight ( less than 1500g) or very preterm ( less than 32 wks' gestation; VLBW/VP) children (n = 267, 124 females, 143 males) and a comparison group born at term (n = 298, 146 females, 152 males) in Germany. Mother-child interactions were videotaped during a play situation and analysed with a standardized coding system at children's mean ages of 6 years 3 months and 8 years 5 months. Results: At both 6 years 3 months and 8 years 5 months, VLBW/VP children were less task persistent and socially active (p less than 0.001) whereas their mothers behaved less sensitively and were more controlling than term mother-child dyads (p less than 0.001). Cross-sectional group differences in maternal behaviour remained when scores where adjusted for social factors but disappeared once adjusted for child IQ. High maternal sensitivity predicted higher task persistence (p less than 0.001), in particular in those children with cognitive problems. Interpretation: Mothers of VLBW/VP children adapt their behaviour to their children's level of cognitive functioning. High maternal sensitivity is particularly beneficial for task persistence in children with cognitive deficits.

Aim: To investigate the strength of the independent associations of mathematics performance in children born very preterm (<32wks' gestation or <1500g birthweight) with attending postsecondary education and their current employment status in young adulthood. Method: We harmonized data from six very preterm birth cohorts from five different countries and carried out one‐stage individual participant data meta‐analyses (n=954, 52% female) using mixed effects logistic regression models. Mathematics scores at 8 to 11 years of age were z‐standardized using contemporary cohort‐specific controls. Outcomes included any postsecondary education, and employment/education status in young adulthood. All models were adjusted for year of birth, gestational age, sex, maternal education, and IQ in childhood. Results: Higher mathematics performance in childhood was independently associated with having attended any postsecondary education (odds ratio [OR] per SD increase in mathematics z‐score: 1.36 [95% confidence interval {CI}: 1.03, 1.79]) but not with current employment/education status (OR 1.14 per SD increase [95% CI: 0.87, 1.48]). Interpretation: Among populations born very preterm, childhood mathematics performance is important for adult educational attainment, but not for employment status. [ABSTRACT FROM AUTHOR]