Barr R G, Rotman A, Yaremko J, Leduc D, Francoeur T E
Department of Pediatrics, McGill University, Montreal, Quebec, Canada.
Pediatrics. 1992 Jul;90(1 Pt 1):14-21.
To obtain a controlled empirical description of some of the measurable clinical features of colic in a naturalistic context, 38 infants whose mothers considered crying a problem ("colic") and 38 pair-matched control infants were observed and videotaped at home 10 minutes before and after an evening feed. The parents kept a diary of infant behaviors (including crying and fussing) for 7 days following the visit. Following Wessel et al (Pediatrics. 1954;14:421-434), each "colic" infant was classified according to the number of days per week that crying and fussing duration was greater than 3 h/d. The distribution of infants with colic suggested that there were two subgroups: Wessel's colic infants, with 3 days or more per week of more than 3 hours of crying and fussing per day; and non-Wessel's colic infants, with fewer such days. Maternal measures of total daily crying/fussing duration, crying/fussing bout length, and infant temperament and objective analyses of facial activity showed a consistent pattern of differences in which Wessel's colic infants differed from both non-Wessel's colic and control infants, who in turn did not differ from each other. Both colic groups differed from control infants only in the perception of postfeed cries as being more "sick sounding." The results imply that the complaint of colic represents two (or more) groups and that there may be meaningfully distinct colic syndromes. They also provide the first independent empirical support for Wessel and colleagues' clinical distinction between "fussy" and "contented" babies.
为在自然环境中获得对一些可测量的绞痛临床特征的对照实证描述,对38名母亲认为其哭闹是个问题(“绞痛”)的婴儿和38名配对的对照婴儿在傍晚喂奶前后各10分钟在家中进行观察并录像。父母在访视后的7天里记录婴儿的行为(包括哭闹和烦躁)日记。按照韦塞尔等人(《儿科学》。1954年;14:421 - 434)的方法,根据每周哭闹和烦躁持续时间大于3小时/天的天数对每个“绞痛”婴儿进行分类。绞痛婴儿的分布表明存在两个亚组:韦塞尔型绞痛婴儿,每周有3天或更多天数每天哭闹和烦躁超过3小时;非韦塞尔型绞痛婴儿,此类天数较少。母亲对每日哭闹/烦躁总时长、哭闹/烦躁发作时长的测量以及婴儿气质和面部活动的客观分析显示出一种一致的差异模式,即韦塞尔型绞痛婴儿与非韦塞尔型绞痛婴儿及对照婴儿均不同,而后两者彼此之间无差异。两个绞痛组与对照婴儿的差异仅在于对喂奶后哭声“听起来更病态”的感知。结果表明,绞痛的主诉代表两个(或更多)组,可能存在有意义的不同绞痛综合征。它们还为韦塞尔及其同事对“烦躁”和“安静”婴儿的临床区分提供了首个独立的实证支持。