Treyvaud Karli, Aldana Andrea C, Scratch Shannon E, Ure Alexandra M, Pace Carmen C, Doyle Lex W, Anderson Peter J
LaTrobe University, Victoria, Australia; Murdoch Childrens Research Institute, Victoria, Australia; University of Melbourne, Victoria, Australia; Royal Women's Hospital, Victoria, Australia.
Universite Laval, Quebec, Canada.
Early Hum Dev. 2016 Sep;100:1-5. doi: 10.1016/j.earlhumdev.2016.04.005. Epub 2016 Jul 9.
Psychological distress has been reported by mothers of infants born very preterm (VPT) and by mothers of multiples (twins and triplets). This study examined the influence of i) multiple birth and ii) bereavement associated with a multifetal pregnancy, on mental health, parenting stress and family functioning for mothers of children born VPT across early childhood.
Participants were 162 mothers of 194 infants (129 singletons, 65 multiples) born at <30weeks' gestation or with a birth weight<1250g who completed questionnaires when their children were two and seven years corrected age. Fifteen mothers (9%) experienced bereavement associated with a multifetal pregnancy. Maternal mental health was assessed using the General Health Questionnaire at two years and Hospital Anxiety and Depression Scale at seven years. Parenting stress and family functioning were assessed using the Parenting Stress Index and Family Assessment Device.
Maternal mental health, stress and family functioning were similar in mothers of VPT singletons and multiples. However compared with mothers who had not experienced bereavement, mothers who had were 3.6 times [95% confidence interval (95% CI) 1.05, 12.5] more likely to report elevated anxiety symptoms and 3.6 times [95% CI 1.05, 12.3] more likely to report elevated depressive symptoms when their VPT child was seven years old.
The results of this study highlight the need for monitoring and offering ongoing support to bereaved mothers with surviving VPT children. However, within the context of VPT birth, multiple birth does not increase the risk for maternal psychological distress in early childhood.
据报道，极早产儿（VPT）的母亲以及多胞胎（双胞胎和三胞胎）的母亲存在心理困扰。本研究探讨了以下两方面因素对VPT儿童母亲在幼儿期心理健康、育儿压力和家庭功能的影响：i）多胞胎生育；ii）与多胎妊娠相关的丧亲之痛。
研究对象为194名婴儿的162位母亲（129名单胎，65名多胎），这些婴儿出生时孕周小于30周或出生体重小于1250克，母亲们在孩子矫正年龄两岁和七岁时完成问卷调查。15位母亲（9%）经历了与多胎妊娠相关的丧亲之痛。使用一般健康问卷在孩子两岁时评估母亲的心理健康状况，在孩子七岁时使用医院焦虑抑郁量表进行评估。使用育儿压力指数和家庭评估工具评估育儿压力和家庭功能。
VPT单胎和多胎母亲的心理健康、压力和家庭功能相似。然而，与未经历丧亲之痛的母亲相比，经历丧亲之痛的母亲在其VPT孩子七岁时报告焦虑症状升高的可能性高出3.6倍[95%置信区间（95%CI）1.05，12.5]，报告抑郁症状升高的可能性高出3.6倍[95%CI 1.05，12.3]。
本研究结果强调了对有存活VPT儿童的丧亲母亲进行监测并持续提供支持的必要性。然而，在VPT出生的背景下，多胞胎生育并不会增加母亲在幼儿期出现心理困扰的风险。
