A mother’s warm, timely, and appropriate responses to her child’s needs support the child’s development and help protect against emotional and behavioral difficulties later in life. A new study shows that sensitive parent–child interactions help reduce risks associated with preterm birth.

A large international study led by the University of Oulu, Finland, shows that early interaction between parent and child plays a key role in child development.

Children born prematurely, that is, before 37 weeks of gestation, have a higher risk of emotional and behavioral problems compared to those born at term. The earlier the child is born, the higher the risk.

These challenges may appear in attention, social interaction, and emotion regulation, and they often persist in adolescence and adulthood.

Sensitivity can be developed

The findings show that a mother’s sensitive interaction—her ability to respond to her child’s signals in a warm and appropriate way—supports the child’s development. This is associated with fewer emotional and behavioral problems years later regardless of how prematurely the child was born.

“This study provides important new evidence showing that early interaction is significant in reducing the risks associated with preterm birth. Maternal sensitivity acts as a modifiable factor through which the effects of prematurity on later development are conveyed,” says Elina Jokiranta-Olkoniemi, University Lecturer at the University of Oulu.

“The finding underscores the importance of preventive efforts in supporting a child’s psychological development. In addition to its world-class neonatal care, Finland has a uniquely comprehensive child health clinic system that reaches virtually all families with children. This system could be used to provide systematic support for sensitive parent–child interaction.”

Key findings:

• Preterm birth increases the risk of emotional and behavioral problems
• High maternal sensitivity can reduce children’s emotional and behavioral problems
• Sensitive interactions between mother and child benefit both preterm and full-term children
• The results were consistent across all participating countries: Germany, The Netherlands, Australia, New Zealand and Israel.

The study is based on a large dataset: 2,469 mother–child pairs from seven longitudinal birth cohorts in five countries in Europe and Oceania. The children were born between 1980 and 2014.

The same pattern of findings was observed in a subgroup of 1,062 mother–child pairs who were followed into adolescence.

The findings offer concrete evidence that parent–child interaction is a central factor in child development, and that supportive, responsive parenting should be systematically promoted from an early stage, especially after preterm birth.

“The study strengthens our understanding that early-life environmental factors can play a decisive role in a child’s developmental pathway, even when the starting point is vulnerable. Interventions that enhance maternal sensitivity should be further studied, and implemented, as they can help reduce emotional and behavioral difficulties as preterm children grow up,” says Julia Jäkel, Professor at the University Hospital Essen, Germany, previously at the University of Oulu.

Based on the findings, approaches that strengthen sensitive parent–child interaction can be applied in the parenting support programs, newborn and pediatric healthcare, early intervention services, and the work of schools and mental health services.

The study Emotional and behavioural problems of children born preterm and maternal sensitivity: An individual participant data meta-analysis has been published July 9, 2026 in the scientific journal Developmental Medicine & Child Neurology: Elina Jokiranta-Olkoniemi, Karli Treyvaud, Dieter Wolke, Günter Esser, Lianne J. Woodward, Alicia Spittle, Jeanie L. Y. Cheong, Anneloes L. van Baar, Marjolein Verhoeven, Noa Gueron-Sela, Naama Atzaba-Poria, Peter J. Anderson & Julia Jaekel.