Department of Pediatrics, Johns Hopkins University School of Medicine, 200 North Wolfe Street, Baltimore, MD 21287, USA.
Matern Child Health J. 2012 Oct;16(7):1413-20. doi: 10.1007/s10995-011-0909-3.
Prior research indicates that closely spaced births are associated with poor outcomes for the mother and subsequent child. Limited research has focused on outcomes for the index child (the child born immediately prior to a subsequent child in a birth interval). The objectives are to assess the association of short birth intervals in at-risk families with: (1) indicators of harsh and neglectful parenting behaviors towards the index child, including substantiated maltreatment reports across 6 years; and (2) the index child's behavior and development in first grade. This is a longitudinal study of 658 women screened to be at-risk for child maltreatment. Twenty percent of women had a rapid repeat birth (RRB), defined as the birth of a subsequent child within 24 months of the index child. Generalized estimating equations, survival analyses, and linear and logistic regression models were used to assess the associations between RRB and index child outcomes. Women with an RRB were more likely than those without an RRB to report neglectful parenting of the index child. Children of mothers with an RRB were more likely than children of mothers without an RRB to have more behavioral problems and lower cognitive functioning in first grade. This study is among the first to focus on the associations of birth spacing with maltreatment, behavior and development outcomes in the index child. Future work regarding the effects of birth spacing should include a focus on the index child.
先前的研究表明，分娩间隔过近与母婴不良结局有关。有限的研究集中在索引儿童（分娩间隔中紧随其后的孩子）的结局上。本研究旨在评估高危家庭中短的生育间隔与以下方面的关联：（1）针对索引儿童的严厉和忽视养育行为的指标，包括 6 年内证实的虐待报告；（2）索引儿童在一年级的行为和发展。这是一项对 658 名筛查出有儿童虐待风险的妇女进行的纵向研究。20%的妇女有快速重复生育（RRB），定义为在索引儿童出生后 24 个月内生育后续孩子。使用广义估计方程、生存分析以及线性和逻辑回归模型来评估 RRB 与索引儿童结局之间的关联。与没有 RRB 的妇女相比，RRB 的妇女更有可能报告对索引儿童的忽视性养育。与没有 RRB 的母亲的孩子相比，RRB 母亲的孩子在一年级时更有可能表现出更多的行为问题和较低的认知功能。本研究是首批关注生育间隔与索引儿童虐待、行为和发展结局之间关联的研究之一。关于生育间隔影响的未来研究应关注索引儿童。
