Protective factors of mental health in a premature population: a 14-year exploratory study across developmental stages

Background: Every year, more premature infants grow into adulthood, yet while extensive research has focused on the risks associated with prematurity, information is scarce regarding the protective factors that can support mental health in these individuals. The aim of this study was to evaluate the impact of proxies for social and educational functioning on their mental health across different developmental stages (childhood, adolescence and adulthood). Methods: In this 14-year developmental study, 50 premature infants were assessed using Achenbach's behavioral scales, including the Child Behavior Checklist (CBCL), Adult Behavior Checklist (ABCL), and Adult Self-Report (ASR). Results: The findings of this exploratory study revealed that while most participants fell within the normative range, 10-20% displayed low social functioning proxies during childhood and adolescence. Notably, the social functioning proxies were significantly associated with internalizing and externalizing symptoms, as well as overall mental health, particularly during adolescence and adulthood. Furthermore, the educational functioning proxies emerged as a key protective factor in adulthood. Conclusions: These results emphasize the importance of fostering strong social and educational functioning throughout life to mitigate mental health risks associated with prematurity. As an exploratory study, these findings suggest that further research is needed to confirm these relationships and enhance the generalizability of the results, with larger and more diverse samples potentially providing more robust insights.