Maternal sensitivity and standardised newborn care

Child engaged in drawing activity, reflecting early cognitive development. © Pexels / Olly

Children born preterm have an increased risk of cognitive and language difficulties. In this context, researchers identify maternal sensitivity as an important and potentially modifiable early-life factor influencing long-term development. This international individual participant data meta-analysis combined data from seven birth cohorts in five countries and included 2,560 children. Overall, the study found that higher maternal sensitivity relates to better cognitive and language outcomes. Notably, the strongest associations occurred in children born at lower gestational ages. Together, these findings inform newborn care practices and long-term follow-up for preterm children.

Children born preterm often score lower on cognitive and language tests than those born at term. Therefore, identifying modifiable protective factors remains an important goal in newborn care. Maternal sensitivity describes well-attuned and emotionally warm responses to an infant’s cues. In this study, the researchers examined how maternal sensitivity and gestational age relate to later cognitive and receptive language outcomes.

To address this question, the researchers conducted a one-stage individual participant data meta-analysis using harmonised data from seven longitudinal birth cohorts in Europe and Oceania. They assessed maternal sensitivity through standardised observations. They then measured cognition and receptive language using validated tests. Finally, the analyses adjusted for relevant child and family characteristics.

Why maternal sensitivity in preterm children is important for newborn care

Across cohorts, higher maternal sensitivity related to better cognitive and receptive language scores. Specifically, each standard deviation increase in maternal sensitivity corresponded to higher cognitive and language outcomes. In addition, gestational age independently predicted both outcomes.

Importantly, the link between maternal sensitivity and cognition was stronger in children born at lower gestational ages. This pattern suggests a potential protective effect in those born most preterm. Moreover, the association remained after adjustment for neurodevelopmental impairment. In contrast, for receptive language, maternal sensitivity and gestational age showed additive effects. However, the analysis found no significant interaction.

As expected, children born extremely or very preterm scored lower on cognitive and language measures than those born at term. Nevertheless, maternal sensitivity continued to show a positive association with cognitive outcomes. Overall, results remained consistent across cohorts despite differences in sampling and timing of assessments.

What this means for parents and health professionals

Taken together, the findings show that maternal sensitivity in preterm children relates to improved cognitive and language outcomes across the full range of gestational ages. For health professionals, this supports including approaches that promote sensitive parent–infant interactions in standardised newborn care and follow-up services. Likewise, for parents and families, the results underline the importance of responsive and emotionally warm interactions in everyday care.

In addition, the study provides a basis for discussions between parents and health professionals about how follow-up services support sensitive interactions. Ultimately, greater awareness of evidence-based standards may strengthen consistency in care across settings.

Paper available at: https://pubmed.ncbi.nlm.nih.gov/41655627/
Full list of authors: Jaekel, J; Wolke, D; Esser, G; Woodward, LJ; Spittle, A; Cheong, J; van Baar, AL; Verhoeven, M; Gueron-Sela, N; Atzaba-Poria, N; Anderson, PJ; Treyvaud, K
DOI: 10.1016/j.jpeds.2026.115024