"Does facial emotion recognition mediate the relationship between preterm birth and social skills? - A meta-analysis".

Background: Preterm birth (PB) is prevalent and associated with structural and functional brain alterations which may affect cognitive and behavioural outcomes, including social development. Facial emotion recognition (FER) is one of the main components of social interaction. PB individuals face distinct FER challenges that may impact social skills. Furthermore, both FER and social skills have shown distinctive developmental trajectories in PB individuals compared to term born controls. This study investigates the association between FER and social skills in PB individuals compared to term-born controls.

Objectives: To systematically review and meta-analyse relevant literature on the association between FER and social skills and to summarize the reported differences in FER and social skills between PB individuals and term-born controls of similar age.

Method: a systematic search of peer-reviewed and English written studies was performed in MEDLINE, Web of Science and CINAHL, with an additional forward and backward citation search. Eligible studies included any observational study that had a term-born control sample of similar age with reported FER and social skills measures and/or correlations between them. Quality assessment and data extraction was carried out. Correlation coefficients and Hedges' g for FER and social skills were calculated as effect size indexes. Random effects model and subgroup analysis considering gestational age and age at assessment was performed. Results were summarized using forest plots. I² statistics and Cochran's Q were used to test for heterogeneity.

Results: 8 studies were included (PB = 410, controls =337). Only 3 studies explored the correlation between FER and social skills. The review found a higher correlation between FER and social skills in the PB group (Z = 0.18, CI = -0.03, 0.39) compared to controls (Z = 0.11, CI = -0.03, 0.25). FER was significantly lower in PB individuals (overall g = -1.48; 95%IC = -2.46, -0-5), particularly in very preterm and adolescent subgroups.

Discussion: FER might play a crucial role in the social development of PB individuals compared to those born at term, but existing research in this domain remains limited.