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极早产会对婴儿出生 7 年后的父母心理健康和家庭状况产生影响。

Very preterm birth influences parental mental health and family outcomes seven years after birth.

机构信息

Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia.

Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia.

出版信息

J Pediatr. 2014 Mar;164(3):515-21. doi: 10.1016/j.jpeds.2013.11.001. Epub 2013 Dec 18.

Abstract

OBJECTIVE

To evaluate the long-term influence of very preterm birth on parental mental health, family functioning, and parenting stress at age 2 and 7 years.

STUDY DESIGN

Participants were 183 children born very preterm (<30 weeks gestation; n = 148 families) and 69 term-born children (n = 66 families). When children were age 7 years, parents were assessed based on the Hospital Anxiety and Depression Scale, the Family Assessment Device, the Parenting Stress Index, and the Social Support Questionnaire. Similar measures were evaluated at age 2 years.

RESULTS

When the children were age 7 years, parents of the very preterm-born children were more likely to report moderate to severe anxiety symptoms (P = .03), higher levels of depression symptoms (P = .03), poorer family functioning (P < .05), and higher levels of parenting stress (P < .001) compared with parents of the children born at term. Group differences in parenting stress and family functioning persisted after adjustment for social risk and child neurodevelopmental disability. There was strong evidence of a relationship between family functioning and parent-related stress at age 2 and 7 years (P < .001), but little evidence that parental mental health problems at 2 years were predictive of anxiety (P = .15) or depression (P = .28) at 7 years for parents of very preterm children.

CONCLUSION

These findings demonstrate that very preterm birth has a negative influence on parent and family functioning at 7 years after birth, which for some families is consistent with their functioning at 2 years. These results have implications for the support required by parents of very preterm children.

摘要

目的

评估极早产(<30 孕周)对儿童 2 岁和 7 岁时父母心理健康、家庭功能和育儿压力的长期影响。

研究设计

参与者为 183 名极早产儿(n=148 个家庭)和 69 名足月产儿(n=66 个家庭)。当儿童 7 岁时,基于医院焦虑抑郁量表、家庭评估工具、育儿压力指数和社会支持问卷对父母进行评估。在儿童 2 岁时也进行了类似的评估。

结果

当儿童 7 岁时,极早产儿的父母更有可能报告中度至重度焦虑症状(P=0.03)、更高水平的抑郁症状(P=0.03)、较差的家庭功能(P<.05)和更高水平的育儿压力(P<.001),与足月产儿的父母相比。在调整社会风险和儿童神经发育障碍后,育儿压力和家庭功能的组间差异仍然存在。在 2 岁和 7 岁时,家庭功能与父母相关压力之间存在很强的关系(P<.001),但几乎没有证据表明 2 岁时父母的心理健康问题能预测极早产儿的父母在 7 岁时的焦虑(P=0.15)或抑郁(P=0.28)。

结论

这些发现表明,极早产对儿童出生后 7 岁时的父母和家庭功能有负面影响,对于一些家庭来说,这种影响与他们在 2 岁时的功能一致。这些结果对极早产儿父母所需的支持有一定的启示。

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