Lakshmanan Ashwini, Agni Meghana, Lieu Tracy, Fleegler Eric, Kipke Michele, Friedlich Philippe S, McCormick Marie C, Belfort Mandy B
Center for Fetal and Neonatal Medicine, USC Division of Neonatal Medicine, Children's Hospital Los Angeles; Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, CA, 90027, Los Angeles, USA.
Newborn and Infant Critical Care Unit, Children's Hospital Los Angeles, 4650 Sunset Boulevard, MS #31, CA, 90027, Los Angeles, USA.
Health Qual Life Outcomes. 2017 Feb 16;15(1):38. doi: 10.1186/s12955-017-0602-3.
Little is known about the quality of life of parents and families of preterm infants after discharge from the neonatal intensive care unit (NICU). Our aims were (1) to describe the impact of preterm birth on parents and families and (2) and to identify potentially modifiable determinants of parent and family impact.
We surveyed 196 parents of preterm infants <24 months corrected age in 3 specialty clinics (82% response rate). Primary outcomes were: (1) the Impact on Family Scale total score; and (2) the Infant Toddler Quality of Life parent emotion and (3) time limitations scores. Potentially modifiable factors were use of community-based services, financial burdens, and health-related social problems. We estimated associations of potentially modifiable factors with outcomes, adjusting for socio-demographic and infant characteristics using linear regression.
Median (inter-quartile range) infant gestational age was 28 (26-31) weeks. Higher Impact on Family scores (indicating worse effects on family functioning) were associated with taking ≥3 unpaid hours/week off from work, increased debt, financial worry, unsafe home environment and social isolation. Lower parent emotion scores (indicating greater impact on the parent) were also associated with social isolation and unpaid time off from work. Lower parent time limitations scores were associated with social isolation, unpaid time off from work, financial worry, and an unsafe home environment. In contrast, higher parent time limitations scores (indicating less impact) were associated with enrollment in early intervention and Medicaid.
Interventions to reduce social isolation, lessen financial burden, improve home safety, and increase enrollment in early intervention and Medicaid all have the potential to lessen the impact of preterm birth on parents and families.
关于早产儿从新生儿重症监护病房(NICU)出院后其父母及家庭的生活质量,人们了解甚少。我们的目标是:(1)描述早产对父母及家庭的影响;(2)确定对父母及家庭产生影响的潜在可改变因素。
我们在3家专科诊所对196名矫正年龄小于24个月的早产儿父母进行了调查(回复率为82%)。主要结局指标为:(1)家庭影响量表总分;(2)婴幼儿生活质量父母情绪得分;(3)时间限制得分。潜在可改变因素包括使用社区服务、经济负担和与健康相关的社会问题。我们使用线性回归分析,在调整社会人口学和婴儿特征的基础上,估计潜在可改变因素与结局指标之间的关联。
婴儿胎龄中位数(四分位间距)为28(26 - 31)周。家庭影响得分较高(表明对家庭功能的影响更差)与每周无薪休假≥3小时、债务增加、经济担忧、家庭环境不安全和社会隔离有关。父母情绪得分较低(表明对父母的影响更大)也与社会隔离和无薪休假有关。父母时间限制得分较低与社会隔离、无薪休假、经济担忧和家庭环境不安全有关。相反,父母时间限制得分较高(表明影响较小)与参加早期干预和医疗补助计划有关。
减少社会隔离、减轻经济负担、改善家庭安全以及增加早期干预和医疗补助计划的参与度等干预措施,都有可能减轻早产对父母及家庭的影响。