Abstract
BACKGROUND: Preterm birth and early bonding disruptions such as delayed first cuddling may increase parental vulnerability and support needs in the postnatal period. However, little is known about how these factors interact to shape paternal perceptions of care and unmet support needs across different domains. METHODS: This retrospective cohort study drew on data from 1559 individuals aged 4-52 years and linked parental reports from 940 mothers and 614 fathers. Participants were categorised by gestational age of the children into extremely preterm (≤ 28 weeks), very preterm (29-32 weeks), moderately preterm (33-36 weeks) and term (≥ 37 weeks). Multivariable logistic regression was used to examine associations between gestational age, birth weight percentile and delayed first cuddling with maternal desires for administrative, social and medical support. Perceived quality of care from healthcare providers was also assessed. RESULTS: Mothers of preterm infants who experienced delayed cuddling reported significantly higher needs for administrative, social and medical support compared to mothers of term infants. Delayed cuddling emerged as a consistent predictor of increased support needs across all domains. Mothers of preterm infants were more likely to rate physician care positively, while delayed cuddling and low birth weight percentile were associated with lower satisfaction with midwifery care. Fathers showed similar but less pronounced patterns, with administrative support needs elevated in preterm groups. CONCLUSION: Preterm birth and delayed first cuddling are associated with greater maternal support needs and lower satisfaction with certain aspects of care, particularly midwifery services. These findings underscore the importance of early, well-coordinated and responsive postnatal support structures, especially for mothers of preterm infants and those who experienced bonding disruptions. Tailored interventions addressing administrative, social and emotional support needs may help reduce long-term stress and improve parent-infant outcomes.