Murdoch Childrens Research Institute, Victoria Infant Brain Studies, Melbourne, Australia.
Pediatrics. 2010 Jul;126(1):e171-8. doi: 10.1542/peds.2009-3137. Epub 2010 Jun 14.
The objective of this study was to determine the effects of preventive care at home on child development and primary caregiver mental health at 2 years of age.
A total of 120 very preterm infants (<30 weeks) were assigned randomly to intervention (n = 61) or control (n = 59) groups. The intervention group received the preventive care program (9 home visits over the first year from a physiotherapist and a psychologist, focusing on the parent-infant relationship, the parents' mental health, and the infant's development); and the control group received standard care. At corrected age of 2 years, developmental outcomes were assessed, and primary caregivers completed the Infant-Toddler Social and Emotional Assessment. The mental health of the primary caregivers was assessed with the Hospital Anxiety and Depression Scale.
At 2 years of age, 115 children (96%) were assessed with the Bayley Scales of Infant and Toddler Development III and 100 children (83%) with the Infant-Toddler Social and Emotional Assessment; and 91 (86%) of 106 caregivers completed the Hospital Anxiety and Depression Scale. There were no statistically significant differences in cognitive, language, or motor composite scores between the treatment groups. However, children in the intervention group were reported by their primary caregivers to exhibit less externalizing and dysregulation behaviors and increased competence, compared with control subjects. Primary caregivers in the intervention group reported less anxiety and depression.
A preventive care program for very preterm infants and their families improved behavioral outcomes for infants and reduced anxiety and depression for primary caregivers.
本研究旨在确定家庭预防保健对 2 岁儿童发育和主要照顾者心理健康的影响。
将 120 例极早产儿（<30 周）随机分为干预组（n=61）和对照组（n=59）。干预组接受预防保健计划（9 次家访，由物理治疗师和心理学家提供，重点关注亲子关系、父母心理健康和婴儿发育）；对照组接受标准护理。在纠正年龄 2 岁时，评估发育结果，主要照顾者完成婴儿-幼儿社会情感评估。主要照顾者的心理健康采用医院焦虑抑郁量表进行评估。
2 岁时，115 名儿童（96%）接受贝利婴幼儿发展量表 III 评估，100 名儿童（83%）接受婴儿-幼儿社会情感评估；106 名照顾者中有 91 名（86%）完成医院焦虑抑郁量表评估。治疗组之间认知、语言或运动综合评分无统计学差异。然而，与对照组相比，干预组的儿童被其主要照顾者报告表现出较少的外化和失调行为以及更高的能力。干预组的主要照顾者报告焦虑和抑郁程度较低。
为极早产儿及其家庭提供的预防保健计划改善了婴儿的行为结果，并减轻了主要照顾者的焦虑和抑郁。
