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孕产妇常见精神障碍(CMD)导致的残疾作为儿童慢性营养不良的一个风险因素:横断面研究

Disability due to maternal common mental disorders (CMDs) as a risk factor for chronic childhood malnutrition: cross-sectional study.

作者信息

Cavalcante-Neto Jorge Lopes, Paula Cristiane Silvestre de, Florêncio Telma Maria de Menezes Toledo, Miranda Claudio Torres de

机构信息

MSc. Assistant Professor, Universidade do Estado da Bahia (UNEB), Salvador, BA, Brazil.

PhD. Adjunct Professor, Postgraduate Program on Developmental Disorders, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brazil.

出版信息

Sao Paulo Med J. 2016 May 13;134(3):228-33. doi: 10.1590/1516-3180.2015.02342112.

Abstract

CONTEXT AND OBJECTIVE

The disability associated with maternal common mental disorders (CMDs) is among the possible explanations for the association between chronic childhood malnutrition and CMDs. CMDs may impair the mother's ability to perform her role, particularly in deprived environments. The present study aimed to evaluate whether disability relating to CMDs could be part of the pathway of the association between childhood malnutrition and maternal CMDs.

DESIGN AND SETTING

Cross-sectional study conducted in two institutions: one for malnourished children and another for eutrophic children living in a low-income community in the state of Alagoas, Brazil.

METHOD

The cases consisted of 55 malnourished children aged from 12 to 60 months who were attending a nutritional rehabilitation center, with height-for-age z-scores < 2. The controls were 70 eutrophic children of the same age who were attending a day care center in the same area as the cases. The Self-Report Questionnaire made it possible to identify likely cases of maternal CMD. The Sheehan Disability Scale enabled evaluation of the associated disability.

RESULTS

Chronic childhood malnutrition was significantly associated with maternal disability relating to CMDs (OR = 2.28; 95% CI: 1.02-5.1). The best logistic regression model using chronic childhood malnutrition as the dependent variable included the following independent variables: higher number of people living in the household; absence of the biological father from the household; and maternal disability relating to CMDs.

CONCLUSIONS

If confirmed, the association between chronic childhood malnutrition and maternal disability relating to CMDs may be useful in helping to identify the causal chain between childhood malnutrition and maternal CMDs and to indicate environmental risk factors associated with chronic childhood malnutrition.

摘要

背景与目的

与孕产妇常见精神障碍(CMD)相关的残疾是儿童慢性营养不良与CMD之间关联的可能解释之一。CMD可能损害母亲履行其角色的能力,尤其是在贫困环境中。本研究旨在评估与CMD相关的残疾是否可能是儿童营养不良与孕产妇CMD之间关联途径的一部分。

设计与地点

在两个机构进行的横断面研究:一个是针对营养不良儿童的机构,另一个是针对居住在巴西阿拉戈斯州低收入社区的营养良好儿童的机构。

方法

病例组包括55名年龄在12至60个月之间、正在营养康复中心接受治疗、年龄别身高z评分<2的营养不良儿童。对照组为70名同年龄段、在与病例组相同区域的日托中心接受照料的营养良好儿童。通过自填问卷可以识别可能患有孕产妇CMD的病例。Sheehan残疾量表用于评估相关残疾情况。

结果

儿童慢性营养不良与孕产妇与CMD相关的残疾显著相关(OR = 2.28;95% CI:1.02 - 5.1)。以儿童慢性营养不良为因变量的最佳逻辑回归模型纳入了以下自变量:家庭居住人数较多;家庭中亲生父亲缺失;以及孕产妇与CMD相关的残疾。

结论

如果得到证实,儿童慢性营养不良与孕产妇与CMD相关的残疾之间的关联可能有助于确定儿童营养不良与孕产妇CMD之间的因果链,并指出与儿童慢性营养不良相关的环境危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba31/10496599/ca10a31d87c8/1806-9460-spmj-134-03-228-gf1.jpg

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