Department of Psychosomatics and Health Behavior, Norwegian Institute of Public Health, Oslo, Norway.
Acta Paediatr. 2010 Jan;99(1):52-5. doi: 10.1111/j.1651-2227.2009.01515.x.
Advances in medical treatment in recent years have led to dramatically improved survival rates of children with severe congenital heart defects (CHD). However, very little is known about the psychological consequences for these children, particularly during and after the early period of invasive treatment. In this study, we investigated the extent to which the severity of the CHD affects the child's emotional reactivity at 6 months of age.
We linked prospective data from the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health with a nationwide medical CHD registry and identified 212 infants with CHD in a cohort of 61 299 infants. Mothers reported on their child's emotional reactivity at age 6 months by means of a standardized questionnaire.
Infants with severe to moderate CHD had 60% higher odds for severe emotional reactivity (cut-off at the 85 percentile) compared with healthy infants, after controlling for important maternal and child confounders.
Our study is the first to show elevated emotional reactivity in children with moderate to severe CHD, suggesting a need for special parental attention to soothe their distress. Follow-up studies will show whether this emotional reactivity is transient or an early marker of continuing emotional or behavioural problems.
近年来，医学治疗的进步使得患有严重先天性心脏病（CHD）的儿童的生存率显著提高。然而，对于这些儿童的心理后果，特别是在侵袭性治疗的早期期间和之后，人们知之甚少。在这项研究中，我们研究了 CHD 的严重程度在多大程度上影响儿童在 6 个月大时的情绪反应。
我们将挪威公共卫生研究所进行的挪威母婴队列研究的前瞻性数据与全国性的医学 CHD 登记处联系起来，并在 61299 名婴儿的队列中确定了 212 名患有 CHD 的婴儿。母亲通过标准化问卷报告了他们孩子在 6 个月大时的情绪反应。
在控制了重要的母婴混杂因素后，与健康婴儿相比，患有严重至中度 CHD 的婴儿出现严重情绪反应（85 百分位的截断值）的可能性高 60%。
我们的研究首次表明，患有中重度 CHD 的儿童的情绪反应升高，这表明需要特别关注父母来安抚他们的痛苦。随访研究将表明这种情绪反应是暂时的还是持续的情绪或行为问题的早期标志物。
