Greene Michelle M, Rossman Beverly, Meier Paula, Patra Kousiki
Department of Behavioral Sciences, Rush University Medical Center, 1653 W Congress Parkway, 1200 Kellogg Building, Chicago, IL 60612, United States; Department of Pediatrics, Rush University Medical Center, 1653 W Congress Parkway, 1200 Kellogg Building, Chicago, IL 60612, United States.
College of Nursing, Rush University Medical Center, Chicago, IL, United States.
Early Hum Dev. 2018 Jan;116:33-39. doi: 10.1016/j.earlhumdev.2017.10.008. Epub 2017 Nov 8.
The literature is sparse with respect to the impact of elevated maternal psychological distress in the neonatal intensive care unit (NICU) on later neurodevelopmental outcome in VLBW infants. The objective of this study is to examine the impact of elevated maternal distress, defined as elevated depression, anxiety and perinatal-specific post-traumatic stress, during the NICU hospitalization on VLBW infant ND outcome at 20months corrected age (CA).
This was a prospective study of 69 mothers and their VLBW infants recruited in 2011-2012. Elevated maternal distress was collected by maternal questionnaire in the NICU. Elevated depression was quantified with the Center for Epidemiological Studies-Depression Scale, anxiety with the Spielberger State-Trait Anxiety Inventory and perinatal-specific post-traumatic stress with the Modified Perinatal Posttraumatic Stress Disorder Questionnaire. VLBW infant ND outcome was assessed using the Bayley Scales of Infant & Toddler Development-III at 20months CA. Regression analyses determined the impact of elevated distress on ND outcome after adjusting for infant medical and maternal sociodemographic variables.
After controlling for infant and maternal covariates, elevated maternal anxiety in the NICU predicted lower fine motor scores at 20months CA.
Elevated maternal anxiety in the NICU is associated with adverse ND outcome in VLBW infants in the 2nd year of life. NICU-based support services may help mothers' quality of life and VLBW infant outcome.
关于新生儿重症监护病房(NICU)中母亲心理困扰加剧对极低出生体重(VLBW)婴儿后期神经发育结局的影响,相关文献较少。本研究的目的是探讨在NICU住院期间,母亲困扰加剧(定义为抑郁、焦虑及围产期特定创伤后应激反应加剧)对VLBW婴儿在20个月矫正年龄(CA)时神经发育(ND)结局的影响。
这是一项对2011 - 2012年招募的69位母亲及其VLBW婴儿进行的前瞻性研究。通过母亲在NICU的问卷调查收集母亲困扰加剧的情况。使用流行病学研究中心抑郁量表对抑郁加剧进行量化,用斯皮尔伯格状态 - 特质焦虑量表评估焦虑,并用改良的围产期创伤后应激障碍问卷评估围产期特定创伤后应激反应。在20个月CA时,使用贝利婴幼儿发展量表第三版评估VLBW婴儿的ND结局。回归分析在调整婴儿医学和母亲社会人口统计学变量后,确定困扰加剧对ND结局的影响。
在控制了婴儿和母亲的协变量后,NICU中母亲焦虑加剧预示着在20个月CA时精细运动得分较低。
NICU中母亲焦虑加剧与VLBW婴儿在生命第二年的不良ND结局相关。基于NICU的支持服务可能有助于提高母亲的生活质量和VLBW婴儿的结局。