Cho June, Holditch-Davis Diane
1School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
Biol Res Nurs. 2014 Apr;16(2):228-36. doi: 10.1177/1099800413486340. Epub 2013 May 2.
Many researchers and health care providers have noticed male vulnerability in infant health, mother-infant interactions, and some infant cognitive development, especially among very low birth weight (VLBW) preterm infants. However, factors beyond gender that could explain these observed differences have not been clear. The purpose of this article is to review the literature on the subject and to introduce a conceptual framework relating these factors.
According to gender-difference theories, prenatal exposure to high levels of testosterone may influence infant health and mother-infant interactions by negatively affecting infant cognitive/motor/language development. We constructed a conceptual framework based on the associations among biological (perinatal testosterone), stress-related (perinatal and maternal cortisol), and developmental (infant cognitive/motor/language skills) factors. If research establishes these biological, environmental, and developmental associations in mother-VLBW preterm pairs, the results will highlight the importance of addressing gender differences in nursing research and encourage the development of nursing interventions designed to reduce stress among mothers of VLBW preterm infants, particularly male infants.
From a psychobiosocial perspective, combining biophysiological factors such as perinatal testosterone and cortisol with socioenvironmental factors such as the quality of mother-infant interactions and infant temperament may provide a broader view of gender differences in infant health and development.
许多研究人员和医疗保健提供者已经注意到男性在婴儿健康、母婴互动以及一些婴儿认知发展方面的脆弱性,尤其是在极低出生体重(VLBW)的早产儿中。然而,除性别之外,能够解释这些观察到的差异的因素尚不清楚。本文的目的是回顾关于该主题的文献,并介绍一个将这些因素联系起来的概念框架。
根据性别差异理论,产前暴露于高水平的睾酮可能会通过对婴儿认知/运动/语言发展产生负面影响,从而影响婴儿健康和母婴互动。我们基于生物学因素(围产期睾酮)、压力相关因素(围产期和母体皮质醇)以及发育因素(婴儿认知/运动/语言技能)之间的关联构建了一个概念框架。如果研究证实了母亲与极低出生体重早产儿之间存在这些生物学、环境和发育方面的关联,那么研究结果将凸显在护理研究中关注性别差异的重要性,并鼓励开发旨在减轻极低出生体重早产儿母亲,尤其是男婴母亲压力的护理干预措施。
从心理生物社会学的角度来看,将围产期睾酮和皮质醇等生物生理因素与母婴互动质量和婴儿气质等社会环境因素相结合,可能会为婴儿健康和发育中的性别差异提供更广阔的视角。