Rauh V A, Achenbach T M, Nurcombe B, Howell C T, Teti D M
Center for Population and Family Health, Columbia University, School of Public Health, New York, NY 10032.
Child Dev. 1988 Jun;59(3):544-53.
The outcome of an early intervention program for low-birthweight (LBW) infants was examined in this study. The intervention consisted of 11 sessions, beginning during the final week of hospitalization and extending into the home over a 3-month period. The program aimed to facilitate maternal adjustment to the care of a LBW infant, and, indirectly, to enhance the child's development. Neonates weighing less than 2,200 grams and under 37 weeks gestational age were randomly assigned to experimental or control conditions. A full-term, normal birthweight (NBW) group served as a second control. 6-month analyses of dyads who completed all assessments over a 4-year period (N's = 25 LBW experimental, 29 LBW control, and 28 NBW infant-mother dyads) showed that the experimental group mothers reported significantly greater self-confidence and satisfaction with mothering, as well as more favorable perception of infant temperament than LBW control group mothers. A progressive divergence between the LBW experimental and LBW control children on cognitive scores culminated in significant group differences on the McCarthy GCI at ages 36 and 48 months, when the LBW experimental group caught up to the NBW group. Possible explanations for the observed delay in the emergence of intervention effects on cognitive development and the mediating role of favorable mother-infant transactional patterns are discussed in light of recent evidence from the literature.
本研究考察了一项针对低体重（LBW）婴儿的早期干预项目的效果。干预包括11次课程，从住院的最后一周开始，持续3个月并延伸至家中。该项目旨在促进母亲适应低体重婴儿的护理，并间接促进儿童的发育。体重小于2200克且孕周小于37周的新生儿被随机分配到实验组或对照组。一个足月、正常出生体重（NBW）组作为第二个对照组。对在4年期间完成所有评估的二元组进行的6个月分析（N分别为25个LBW实验组、29个LBW对照组和28个NBW婴儿-母亲二元组）表明，与LBW对照组母亲相比，实验组母亲报告的自信心和育儿满意度显著更高，对婴儿气质的看法也更积极。LBW实验组和LBW对照组儿童在认知分数上的逐渐差异在36个月和48个月时在麦卡锡GCI上出现显著的组间差异，此时LBW实验组赶上了NBW组。根据文献中的最新证据，讨论了观察到的干预对认知发展影响出现延迟的可能原因以及良好母婴互动模式的中介作用。
