2025

Background

Preterm birth, being born before your due date, can be associated with changes to brain development and challenges during childhood and beyond, such as cerebral palsy (movement problems), learning difficulties, vision or hearing problems, and mental health problems. 

Socioeconomic status (SES) refers to an individual's social standing, which is affected by their access to financial, educational, social, and health resources. In babies, SES may be measured at three levels: 

1. Neighbourhood deprivation - how deprived or rich a neighbourhood is. In Scotland, this is captured using the Scottish Index of Multiple Deprivation (SIMD): a postcode-based score that includes neighbourhood-level information about income, employment, health, education, housing, crime, and access to services.
2. Family SES - parental education level and occupation.
3. Subjective SES - a measure of how someone perceives their social standing and quality of life.

Lower, compared to higher, SES is associated with differences in child brain structure and an increased chance of developing learning difficulties and mental health problems.

We previously studied how preterm birth and a family’s socioeconomic status relates to brain structures in the neonatal period, around their due date, and found that they both had effects. White matter is the parts of the brain connecting different brain regions, and we already know it is important for outcomes in babies born preterm. We now wanted to look at how preterm birth and a family’s socioeconomic status related to development of the white matter of the brain across childhood, in the neonatal period and at five years of age. 

Research questions

We looked at how preterm birth and low socioeconomic status relate to white matter in the brain in newborn babies around their due date and at five years. We also looked at whether this relationship is different depending on what we used to describe socioeconomic status.

Findings

In the neonatal period among preterm babies, those who were born closer to term (i.e. with higher gestational age) had more “mature” white matter. Similarly, children whose mothers had higher education also showed more mature white matter. In contrast, the neighbourhood-level measure did not show a strong association at this age. 

At five years old for preterm-born children, the story changes slightly. The link between how early they were born and their white matter structure depended more on neighbourhood-level deprivation (rather than maternal education). 

In other words, both preterm birth and socioeconomic environment matter — but their relative importance changes over time.

Conclusions

Brain development is shaped by more than just biology and medical factors. When babies are born early, they are biologically more vulnerable — but their postnatal environment, including socioeconomic conditions, also plays a role. The influence of social conditions changes over time. Right after birth, family-level factors (like maternal education) seem more important; by early childhood, broader neighbourhood-level factors become more relevant.

We don’t yet know how preterm birth and poverty affect brain structure. However, supporting families and reducing poverty, or the effects of poverty, could improve preterm brain development. Our results suggest we might need to adapt what interventions we give as children grow, supporting families in early life, and focusing on the wider neighbourhood as they grow up.

Background information

Babies born prematurely, before 37 weeks of gestation, may experience difficulties with motor coordination, and social and emotional adjustment. 

Whe studying movement and behaviour in natural environments or in laboratory observations, researchers tend to focus on the average of a movement quality (e.g., kinematic acceleration) or the amount of a type of behaviour. 

There have been advances in computational methods that quantify motor kinematic dynamics, in other words patterns of change from one moment to the next. One such measure is entropy, which measures how complex a signal is. Similar methods have been applied to behavioural data, although these are still relatively novel.

Previous work suggest that entropy is sensitive to context and motor development, and that lower entropy may potentially capture stereotypical movements or generic developmental risks. In this proof-of-concept study, we use computational dynamic measures to investigate movement and behaviour in contexts where infants respond to different levels of social interaction and emotional stress. 

Research questions

Do motor kinematic dynamics and behavioural dynamics differ amongst babies born prematurely and babies born at full-term?

How does context (differing in social interaction and stress levels) affect these motor and behavioural markers?

Findings

Motor kinematic dynamics were sensitive to social interactive and emotional demands in both groups of babies. 

We also found greater left ankle and torso entropy amongst babies born prematurely compared to babies born at full term. This pattern of difference potentially reflects differences in motor development and cerebral lateralisation in babies born prematurely, rather than an indication of stereotypical movements or being at developmental risk.

We did not find differences between groups or between contexts, when analysing the behavioural dynamics.

Conclusions

We found preliminary evidence of differences in movement dynamics between babies born prematurely and babies born at term. Measures of movement dynamics are scalable to real-world data collection and can be useful early markers of developmental health, but our findings still need to be replicated in larger samples and validated. Furthermore, analysis of behavioural dynamics still require methodological development.

Background Information

Preterm birth, which is when a baby is born before 37 weeks of pregnancy, has been linked to a higher risk of language difficulties and delays in children. Additionally, socio-economic status, which refers to a person's social and economic position in society, has also been shown to impact language development in children. Children from lower socio-economic backgrounds tend to have less exposure to rich and complex language, which can affect their language skills. This study aimed to investigate how prematurity and socio-economic status affect the language exposure of infants.

Research Question

The researchers asked two main questions: (1) Do parents of preterm infants communicate differently with their babies compared to parents of term-born infants? and (2) How do factors related to socio-economic status, such as neighbourhood deprivation and maternal education, influence parental communication with their infants? To answer these questions, the study involved 100 participants, including 47 preterm infants and 53 term-born infants, whose parents engaged in a 10-minute free play session with their babies at 9 months of age. The sessions were video-recorded and coded for parental language and gesture use. The researchers also collected data on the parents' socio-economic status, including neighbourhood deprivation, maternal education, and quality of life.

Findings

The study found that parents of preterm and term-born infants communicated similarly with their babies in terms of the amount and type of language used. However, socio-economic status played a significant role in shaping parental communication. Parents from higher socio-economic backgrounds used more words, had a greater variety of words, and used longer sentences when speaking to their infants. The researchers also found that neighbourhood deprivation was a stronger predictor of parental language use than maternal education or quality of life.

Conclusions

The study's findings suggest that socio-economic status, rather than prematurity, is a key factor in determining the language environment of infants. This has important implications for policymakers and healthcare professionals, as it highlights the need to support families from disadvantaged backgrounds to provide a rich and stimulating language environment for their children. By doing so, we can help reduce the risk of language delays and difficulties in preterm and term-born infants alike, and promote better language and communication skills in all children.