Premature babies make fewer friends and spend less time socialising in early childhood, according to a study.
However, these children make more friends and gain more acceptance from peers after they enter elementary school.
"Having friends, playing with them and being accepted is important for social support and personal well-being," said Professor Dieter Wolke, from the University of Warwick in the UK.
"Having fewer friends, feeling less accepted can lead to feelings of loneliness and increases the risk of being excluded or bullied," Wolke said.
For the study, published in The Journal of Pediatrics, researchers analysed over 1,000 children.
Of these, 179 were born very premature (under 32 weeks gestational age), 737 were moderately-to-late preterm (born between 32 and 36 weeks) and 231 were healthy full-term babies (born between 37 and 41 weeks gestation).
The children and parents were also asked to complete a picture quiz to determine how they felt they were perceived by their peers.
It was found that children who were born very preterm reported on average four friends, while full term born children had five friends, by age six.
"Entering school increases social networks and should be a consideration when contemplating delaying school entry for preterm children," Wolke said.
"Although most preterm children catch up with their full term peers during early elementary school, future interventions to improve friendships and social interaction skills should start before school entry to prevent later psychopathology and behaviour problems," Wolke added.
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