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Objective Parental perception of a child vulnerability (PPCV) to illness, not justified by medically noticeable symptoms, is a situation well known to medical and paramedical staff. It is still disputed whether PPCV is triggered by the child’s health problems or by parental emotional status. This review is aimed to clarify the etiology of PPCV in instances of preterm birth. Method PRISMA guidelines were followed. MEDLINE and Scopus indexes were searched. Of the 70 articles yielded by the search, 14 met the inclusion criteria for the systematic review, of which 10 could be included in the meta-analysis. Results Children’s physiological factors and parents’ psychological factors were both found to significantly influence PPCV, in different ways, at different ages of the child. Conclusion PPCV etiology appears to mostly depend on parents’ psychological factors. A better understanding of PPCV etiology could help protect children from distorted parental interaction and reduce parental demands for unnecessary medical care.