Anand Vibha, Downs Stephen M, Bauer Nerissa S, Carroll Aaron E
*Pediatric Institute, Cleveland Clinic, Cleveland, OH; †Children's Health Services Research, Indiana University School of Medicine, Indianapolis, IN; and ‡The Regenstrief Institute for Health Care, Indianapolis, IN.
J Dev Behav Pediatr. 2014 Apr;35(3):216-24. doi: 10.1097/DBP.0000000000000035.
Early television (TV) viewing has been linked with maternal depression and has adverse health effects in children. However, it is not known how early TV viewing occurs. This study evaluated the prevalence at which parents report TV viewing for their children if asked in the first 2 years of life and whether TV viewing is associated with maternal depression symptoms.
Using a cross-sectional design, TV viewing was evaluated in children 0 to 2 years of age in 4 pediatric clinics in Indianapolis, IN, between January 2011 and April 2012. Families were screened for any parental report of depression symptoms (0-15 months) and for parental report of TV viewing (before 2 years of age) using a computerized clinical decision support system linked to the patient's electronic health record.
There were 3254 children in the study. By parent report, 50% of children view TV by 2 months of age, 75% by 4 months of age, and 90% by 2 years of age. Complete data for both TV viewing and maternal depression symptoms were available for 2397 (74%) of children. In regression models, the odds of parental report of TV viewing increased by 27% for each additional month of child's age (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.25-1.30; p < .001). The odds of TV viewing increased by almost half with parental report of depression symptoms (OR, 1.47; CI, 1.07-2.00, p = .016). Publicly insured children had 3 times the odds of TV viewing compared to children with private insurance (OR, 3.00; CI, 1.60-5.63; p = .001). Black children had almost 4 times the odds (OR, 3.75; CI, 2.70-5.21; p < .001), and white children had one-and-a-half times the odds (OR, 1.55; CI, 1.04-2.30; p = .032) of TV viewing when compared to Latino children.
By parental report, TV viewing occurs at a very young age in infancy, usually between 0 and 3 months and varies by insurance and race/ethnicity. Children whose parents report depression symptoms are especially at risk for early TV viewing. Like maternal depression, TV viewing poses added risks for reduced interpersonal interactions to stimulate infant development. This work suggests the need to develop early targeted developmental interventions. Children as young as 0 to 3 months are viewing TV on most days. In the study sample of 0 to 2 year olds, the odds of TV viewing increased by more than a quarter for each additional month of child's age and by as much as half when the mother screened positive for depression symptoms.
早期看电视与母亲抑郁有关,且对儿童健康有不良影响。然而,尚不清楚早期看电视的情况是如何发生的。本研究评估了如果在孩子出生后的头两年被问到,父母报告孩子看电视的比例,以及看电视是否与母亲抑郁症状有关。
采用横断面设计,于2011年1月至2012年4月在印第安纳州印第安纳波利斯市的4家儿科诊所对0至2岁的儿童进行看电视情况评估。使用与患者电子健康记录相连的计算机化临床决策支持系统,对家庭进行筛查,以获取父母关于抑郁症状(0至15个月)的报告以及父母关于看电视(2岁之前)的报告。
本研究中有3254名儿童。据父母报告,50%的儿童在2个月大时就开始看电视,75%在4个月大时开始看电视,90%在2岁时开始看电视。2397名(74%)儿童有看电视和母亲抑郁症状的完整数据。在回归模型中,孩子每长大一个月,父母报告孩子看电视的几率就增加27%(优势比[OR]为1.27;95%置信区间[CI]为1.25 - 1.30;p <.001)。父母报告有抑郁症状时,孩子看电视的几率增加近一半(OR为1.47;CI为1.07 - 2.00;p = 0.016)。与有私人保险的儿童相比,参加公共保险的儿童看电视的几率是其3倍(OR为3.00;CI为1.60 - 5.63;p = 0.001)。与拉丁裔儿童相比,黑人儿童看电视的几率几乎是其4倍(OR为3.75;CI为2.70 - 5.21;p <.001),白人儿童看电视的几率是其1.5倍(OR为1.55;CI为1.04 - 2.30;p = 0.032)。
据父母报告,婴儿在很小的时候就开始看电视,通常在0至3个月之间,且因保险类型和种族/族裔而异。父母报告有抑郁症状的孩子尤其有早期看电视的风险。与母亲抑郁一样,看电视会增加减少人际互动以刺激婴儿发育的风险。这项研究表明需要制定早期针对性的发育干预措施。0至3个月大的儿童大多数日子都在看电视。在0至2岁儿童的研究样本中,孩子每长大一个月,看电视的几率就增加超过四分之一,当母亲抑郁症状筛查呈阳性时,几率增加多达一半。