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前晚期早产儿有儿童脆弱性和过度保护的风险吗?

Are former late-preterm children at risk for child vulnerability and overprotection?

机构信息

South Dakota State University, College of Nursing, Brookings, SD 57007, United States.

出版信息

Early Hum Dev. 2010 Sep;86(9):557-62. doi: 10.1016/j.earlhumdev.2010.07.005. Epub 2010 Aug 8.

DOI:10.1016/j.earlhumdev.2010.07.005
PMID:20696540
Abstract

BACKGROUND

Parent perception of child vulnerability (PPCV) and parent overprotection (POP) are believed to have serious implications for age appropriate cognitive and psychosocial development in very low birth weight preterm children.

AIM

With recent concerns about suboptimal developmental outcomes in late-preterm children, this study was aimed at examining the relationship between history of late-preterm birth (34-36 6/7 weeks gestation), and PPCV, POP, and healthcare utilization (HCU).

STUDY DESIGN

This was a cross-sectional observational design.

PARTICIPANTS

Study participants were mothers of 54 healthy singleton children recruited from community centers including Women and Children Clinics (WIC), primary care clinics and daycare centers in the upper Midwest region.

OUTCOME MEASURES

Outcome measures included Forsyth Child Vulnerability Scale (CVS), Thomasgard Parent Protection Scale (PPS) scores, and healthcare utilization (HCU). Potential covariates included history of life-threatening illness, child and maternal demographics, and maternal stress and depression using the Center for Epidemiologic Studies Depression Scale (CESD).

RESULTS

HCU (p=0.02) and the PPS subscales of supervision (p=0.003) and separation (p=0.03) were significant predictors of PPCV in mothers of 3-8 years old children with late-preterm history. Age of the child (p=0.008) and CVS scores (p=0.005) were significant predictors of POP. Maternal age (p=0.04), stress (p=0.04), and CVS scores (p=0.003) were significant predictors of HCU. Dependence, a subscale of the PPS, correlated with the child's age and gender even after controlling for age.

CONCLUSION

History of late-preterm did not predict MPCV, MOP, or HCU in healthy children. Future research is needed in larger more diverse samples to better understand causal relationships and develop strategies to lessen risks of MPCV and MOP.

摘要

背景

家长对孩子脆弱性的感知(PPCV)和家长过度保护(POP)被认为对极低出生体重早产儿的认知和心理社会发展有严重影响。

目的

鉴于最近对晚期早产儿发育结果不理想的担忧,本研究旨在探讨晚期早产儿出生史(34-36 6/7 周妊娠)与 PPCV、POP 和医疗保健利用(HCU)之间的关系。

研究设计

这是一项横断面观察性设计。

参与者

研究参与者为来自社区中心(包括妇女和儿童诊所(WIC)、初级保健诊所和日托中心)招募的 54 名健康单胎儿童的母亲。

结果测量

结果测量包括福赛思儿童脆弱性量表(CVS)、托马斯加德父母保护量表(PPS)评分和医疗保健利用(HCU)。潜在的协变量包括有生命威胁的疾病史、儿童和母亲的人口统计学特征,以及使用流行病学研究中心抑郁量表(CESD)的母亲压力和抑郁情况。

结果

在有晚期早产儿出生史的 3-8 岁儿童的母亲中,HCU(p=0.02)和 PPS 的监督(p=0.003)和分离(p=0.03)分量表是 PPCV 的显著预测因素。儿童年龄(p=0.008)和 CVS 评分(p=0.005)是 POP 的显著预测因素。母亲年龄(p=0.04)、压力(p=0.04)和 CVS 评分(p=0.003)是 HCU 的显著预测因素。即使在控制年龄后,PPS 的依赖分量表仍与儿童的年龄和性别相关。

结论

晚期早产儿出生史并不能预测健康儿童的 MPCV、MOP 或 HCU。需要在更大、更多样化的样本中进行进一步研究,以更好地理解因果关系,并制定策略来降低 MPCV 和 MOP 的风险。

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