Objectives Infancy is a critical stage of life, and a secure
relationship with caring and responsive caregivers is
crucial for healthy infant development. Early parenting
interventions aim to support families in which infants
are at risk of developmental harm. Our objective is to
systematically review the effects of parenting interventions
on child development and on parent–child relationship for
at-risk families with infants aged 0–12 months.
Design This is a systematic review and meta-analyses.
We extracted publications from 10 databases in June
2013, January 2015 and June 2016, and supplemented
with grey literature and hand search. We assessed risk of
bias, calculated effect sizes and conducted meta-analyses.
Inclusion criteria (1) Randomised controlled trials
of structured psychosocial interventions offered to
at-risk families with infants aged 0–12 months in
Western Organisation for Economic Co-operation and
Development (OECD) countries, (2) interventions with
a minimum of three sessions and at least half of these
delivered postnatally and (3) outcomes reported for child
development or parent–child relationship.
Results Sixteen studies were included. Meta-analyses
were conducted on seven outcomes represented in 13
studies. Parenting interventions significantly improved
child behaviour (d=0.14; 95% CI 0.03 to 0.26), parent–
child relationship (d=0.44; 95% CI 0.09 to 0.80) and
maternal sensitivity (d=0.46; 95% CI 0.26 to 0.65)
postintervention. There were no significant effects on
cognitive development (d=0.13; 95% CI −0.08 to 0.41),
internalising behaviour (d=0.16; 95% CI −0.03 to 0.33)
or externalising behaviour (d=0.16; 95% CI −0.01 to
0.30) post-intervention. At long-term follow-up we found
no significant effect on child behaviour (d=0.15; 95% CI
−0.03 to 0.31).
Conclusions Interventions offered to at-risk families
in the first year of the child’s life appear to improve
child behaviour, parent–child relationship and maternal
sensitivity post-intervention, but not child cognitive
development and internalising or externalising behaviour.
Future studies should incorporate follow-up assessments
to examine long-term effects of early interventions.

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