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婴儿期共病性哭闹、睡眠和喂养问题的发展:神经发育易损性与养育方式

Development of comorbid crying, sleeping, feeding problems across infancy: Neurodevelopmental vulnerability and parenting.

作者信息

Bilgin Ayten, Wolke Dieter

机构信息

Department of Psychology, University of Warwick, Coventry, UK.

Department of Psychology, University of Warwick, Coventry, UK; Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.

出版信息

Early Hum Dev. 2017 Jun;109:37-43. doi: 10.1016/j.earlhumdev.2017.04.002. Epub 2017 Apr 20.

Abstract

BACKGROUND

Regulatory problems (excessive crying, feeding, and sleeping difficulties), specifically their comorbidity, are early warning signs of future problems. Insensitive parenting and neurodevelopmental vulnerabilities have been suggested as factors explaining development or maintenance of regulatory problems. Nevertheless, none of the previous studies investigated these factors within the same sample across infancy, taking into account the reciprocal influences between maternal sensitivity and regulatory problems.

AIM

To investigate the prospective association between very preterm birth, comorbid regulatory problems and maternal sensitivity.

SUBJECTS

178 participants including 73 very preterm/very low birth weight and 105 full-term infants and their caretakers.

STUDY DESIGN

A prospective study from birth to 18months.

MEASURES

Regulatory problems were measured at term, 3months and 18months with a structured parental interview. Maternal sensitivity was measured with a nurse observation at term; and a researcher observation of play tasks at 3months and at 18months.

RESULTS

Very preterm birth was associated with regulatory problems at term (β=0.19, SE=0.10, p<0.05) and at 18months (β=0.21, SE=0.10, p<0.05), while it had no association to maternal sensitivity across infancy. There were no cross-lagged reciprocal effects between maternal sensitivity and regulatory problems across infancy. Maternal sensitivity at term had a negative association to regulatory problems at 3months (β=-0.26, SE=0.12, p<0.05), but not from 3 to 18months.

CONCLUSIONS

Neurodevelopmental vulnerabilities provided more consistent prediction of regulatory problems in comparison to sensitive parenting.

摘要

背景

调节问题(过度哭闹、喂养和睡眠困难),尤其是它们的共病情况,是未来问题的早期预警信号。不敏感的养育方式和神经发育脆弱性被认为是解释调节问题发展或维持的因素。然而,之前的研究都没有在同一个婴儿样本中,在整个婴儿期考察这些因素,同时考虑到母亲敏感性和调节问题之间的相互影响。

目的

研究极早产、共病调节问题与母亲敏感性之间的前瞻性关联。

研究对象

178名参与者,包括73名极早产/极低出生体重儿和105名足月儿及其照顾者。

研究设计

一项从出生到18个月的前瞻性研究。

测量方法

在足月时、3个月和18个月时,通过结构化的家长访谈来测量调节问题。在足月时通过护士观察来测量母亲敏感性;在3个月和18个月时,由研究人员观察游戏任务来测量母亲敏感性。

结果

极早产与足月时(β=0.19,标准误=0.10,p<0.05)和18个月时(β=0.21,标准误=0.10,p<0.05)的调节问题相关,而在整个婴儿期与母亲敏感性无关。在整个婴儿期,母亲敏感性和调节问题之间没有交叉滞后的相互影响。足月时的母亲敏感性与3个月时的调节问题呈负相关(β=-0.26,标准误=0.12,p<0.05),但在3个月至18个月期间没有相关性。

结论

与敏感养育相比,神经发育脆弱性对调节问题的预测更具一致性。

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