Kariuki Maina, Raudino Alessandra, Green Melissa J, Laurens Kristin R, Dean Kimberlie, Brinkman Sally A, Lenroot Rhoshel K, Liu Enwu, Harris Felicity, Luo Luming, Carr Vaughan J
School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.
Schizophrenia Research Institute, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2016 Sep;52(9):882-8. doi: 10.1111/jpc.13239. Epub 2016 Jul 20.
Childhood infectious diseases can be associated with later physical and psychological ill health, and the effects of this association may be evident during early childhood development. This study aimed to examine the effects of hospitalisation for early life infection on early childhood development.
Hospital admission data for infection were obtained from the New South Wales Ministry of Health Admitted Patient Data Collection for 87 026 children, for whom the Australian Early Development Census (AEDC) was completed in their first year of formal schooling (age approximately 5 years). The AEDC provides estimates of each child's level of functioning on five domains of development spanning social and emotional skills, communication skills, numeracy and literacy and physical health. Multinomial logistic regressions were used to determine the relationship between exposure to hospital admissions for infectious disease prior to age 4 years and vulnerability on the AEDC. Models were adjusted for the effects of potential confounding factors related to the perinatal period, exposure to maltreatment and family characteristics.
Single and multiple hospitalisation(s) for infections were consistently associated with increased likelihood of being developmentally vulnerable on all AEDC domains, with odds ratios ranging from 1.02 to 1.28, after adjustment for confounding factors.
This study demonstrates a pervasive effect of early life infections that require hospital admission on multiple aspects of early child development, even after adjustment for potential confounding factors. Relatively, severe infection during early childhood constitutes a risk factor for developmental vulnerability by the time of entry to school.
儿童期传染病可能与日后的身心健康问题相关，这种关联的影响可能在幼儿发育早期就很明显。本研究旨在探讨生命早期感染住院对幼儿发育的影响。
从新南威尔士州卫生部的入院患者数据收集中获取了87026名儿童的感染住院数据，这些儿童在其正式入学的第一年（约5岁）完成了澳大利亚早期发展普查（AEDC）。AEDC对每个儿童在社会和情感技能、沟通技能、读写和算术能力以及身体健康等五个发展领域的功能水平进行评估。采用多项逻辑回归来确定4岁前因传染病住院与AEDC上的易损性之间的关系。模型针对围产期、遭受虐待暴露和家庭特征等潜在混杂因素的影响进行了调整。
在调整混杂因素后，因感染而单次或多次住院与在所有AEDC领域发育易损的可能性增加始终相关，优势比范围为1.02至1.28。
本研究表明，即使在调整了潜在混杂因素之后，需要住院治疗的生命早期感染对幼儿发育的多个方面仍有普遍影响。相对而言，幼儿期的严重感染是入学时发育易损的一个危险因素。
