A new study published in PLOS Mental Health has explored whether having a sibling born preterm (before 37 weeks of gestation) affects the behavior of children born at term. In a study by the University of Oulu, researchers found no evidence that siblings of preterm-born children experience more behavioral problems than those with only term-born siblings. However, children without any siblings showed higher levels of behavioral difficulties.
The study analyzed data from 65,711 children aged 14 and under, using information from birth cohorts in Denmark, Norway, Italy, and the Netherlands. Children were divided into three groups: those with at least one preterm-born sibling, those with only term-born siblings, and those without siblings. Researchers assessed internalizing behaviors—such as anxiety, depression and stress—and externalizing behaviours, including impulsivity, aggression and rule-breaking. Behavioral data were gathered using parental reports via the Strengths and Difficulties Questionnaire and the Child Behaviour Checklist. The results showed that children with preterm-born siblings did not differ significantly in behavioral outcomes compared to those with only term-born siblings.
In contrast, children without siblings had higher internalizing and externalizing scores. While the study did not identify a behavioral risk associated with having a preterm-born sibling, it highlights the need for further research. The authors note that the mental health of siblings and larger sample sizes for specific subgroups should be included in future longitudinal studies. Children with preterm-born siblings remain an understudied group that could potentially be at increased risk of mental health challenges. The researchers emphasize that continued investigation could provide essential evidence for targeted support, especially if future studies reveal specific vulnerabilities among siblings of preterm-born children.
The study analyzed all data using DataSHIELD, an analysis platform which allows remote access to data and aims to facilitate data sharing across institutions, whilst ensuring total data protection. The research was conducted as part of the European Union-funded LifeCycle project but was a larger collaboration involving projects such as LongITools and ATHLETE, part of the European Human Exposome Network. The LifeCycle project created the EU Child Cohort Network (EUCCN), which brings together data from 17 cohorts across Europe and Australia, and is featured in the larger European Health Research Data and Sample Catalogue developed in the other projects.
Source:
Journal reference:
Silva, W., et al. (2025). Internalising and externalising behaviour in siblings of children born preterm Preterm birth: Internalising and externalising behaviour of siblings. PLOS Mental Health. doi.org/10.1371/journal.pmen.0000334.
