Parenting Behavior at 18 Months Predicts Internalizing and Externalizing Problems at 6 Years in Moderately Preterm and Full Term Children.

Moderately preterm born children (MPT) are at increased risk for behavior problems compared to full term born (FT) children. MPT children may receive less optimal parenting, and in response, may develop behavior problems. Our aims were to examine whether parenting behavior and mother-child interaction quality mediate the association between birth status and child behavior problems. Participants were 120 MPT children and 100 FT children. At 18 months of age, mothers reported on their parenting behavior (support and structure), and mother-child interaction (sensitivity and limit-setting) was observed. At 6 years of age, mothers reported on children's behavior problems. Using structural equation modeling, birth status was found to predict attention problems, but not internalizing and externalizing problems. Mothers of MPT children set less appropriate limits than mothers of FT children at 18 months of age. More maternal structure at 18 months predicted fewer internalizing and externalizing problems, but not attention problems, at 6 years. These associations between parenting behavior, mother-child interaction quality, and child behavior problems were similar for MPT and FT children. Our findings indicate that maternal structure in toddlerhood is an important predictor of later internalizing and externalizing problems for both MPT and FT children.