Associations Between Paternal Sensitivity and Cognitive and Behavioural Outcomes in Preterm Children: An Individual Participant Data Meta-Analysis.

BACKGROUND: Children born preterm (PT) face elevated neurodevelopmental risk, yet the role of fathers' sensitive caregiving in this process remains understudied. OBJECTIVE: To test whether observed paternal sensitivity predicts cognitive and behavioural outcomes in PT children and moderates prematurity-related risk. METHODS: Individual participant data (IPD) from two prospective cohorts in Australia and Israel (2009-2014) were pooled (N = 207; 151 PT, 56 term). Father-child and mother-child dyadic interactions at 6-12 months corrected age were observed and coded with the emotional availability (EA) sensitivity scale. Child cognition and behaviour were assessed at 5 years of age. Mixed-effects regressions controlled for sex, age, multiple birth, small-for-gestational-age status and maternal education. RESULTS: Higher paternal sensitivity predicted higher cognitive scores (β = 0.25 per SD, 95% confidence interval = [0.09, 0.41], p < 0.003). Paternal sensitivity was not related to children's later behavioural problems (-0.003 [-0.21, 0.20], p = 0.981). No gestational age × paternal sensitivity interaction emerged. CONCLUSIONS: Sensitive fathering confers an additive, clinically meaningful benefit for cognitive function in both PT and term children, over and above social and medical risk. Early-intervention programs that actively engage fathers and support sensitive responsive interactions may enhance developmental trajectories in this vulnerable population.