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日本环境与儿童研究中的非安慰性胎儿状况和新生儿易激惹:一项队列研究。

Non-reassuring foetal status and neonatal irritability in the Japan Environment and Children's Study: A cohort study.

机构信息

Research Center for Environmental and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan.

Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

Sci Rep. 2018 Oct 26;8(1):15853. doi: 10.1038/s41598-018-34231-y.

Abstract

The aim of this study was to investigate whether non-reassuring foetal status (NRFS) affected an infant's temperament, or if the temperament formed prenatally resulted in an excessive heart rate reaction that was diagnosed as NRFS. We examined the correlation between NRFS and difficulty in holding a baby, and the amount of crying in the one month after birth, which was considered an indicator of the newborn's temperament. We divided the cases with NRFS into positive NRFS and false positive NRFS. NRFS was associated with bad mood, frequent crying for a long duration, and intense crying. After adjustment for other covariates, NRFS was associated with bad mood (odds ratio, OR = 1.15, 95% confidence interval, CI = 1.00-1.33), and intense crying (1.12, 1.02-1.24). In the multi-variable model, positive and false positive NRFS were not clearly associated with neonatal irritability. When stratified by parity, NRFS and false positive NRFS were likely to be positively associated with neonatal irritability in parous women. The clear association between NRFS and intense crying was observed in parous women (multi-variable adjusted OR = 1.46, 95% CI = 1.16-1.83), but not in nulliparae (1.01, 0.91-1.12) (p for effect modification <0.01). Similarly, increased odds of intense crying associated with false positive NRFS were only found in parous women (multi-variable adjusted OR = 1.40, 95% CI = 1.09-1.81) (p for effect modification = 0.03). There was no association observed between positive NRFS and irritability; therefore, NRFS has no effect on an infant's temperament.

摘要

本研究旨在探讨非可信赖胎儿状态(NRFS)是否会影响婴儿的气质,或者是否胎儿期形成的气质会导致过度的心率反应,从而被诊断为 NRFS。我们检查了 NRFS 与抱婴困难以及新生儿出生后一个月内哭泣程度的相关性,这被认为是新生儿气质的一个指标。我们将 NRFS 病例分为阳性 NRFS 和假阳性 NRFS。NRFS 与情绪不佳、长时间频繁哭泣和剧烈哭泣有关。在调整其他协变量后,NRFS 与情绪不佳(比值比,OR=1.15,95%置信区间,CI=1.00-1.33)和剧烈哭泣(1.12,1.02-1.24)有关。在多变量模型中,阳性 NRFS 和假阳性 NRFS 与新生儿易激惹之间没有明显关联。按产次分层时,NRFS 和假阳性 NRFS 与经产妇的新生儿易激惹可能呈正相关。在经产妇中,NRFS 与剧烈哭泣之间存在明显的关联(多变量调整后的 OR=1.46,95%CI=1.16-1.83),但在初产妇中则没有(1.01,0.91-1.12)(p 值为效应修饰<0.01)。同样,仅在经产妇中发现与假阳性 NRFS 相关的剧烈哭泣的可能性增加(多变量调整后的 OR=1.40,95%CI=1.09-1.81)(p 值为效应修饰=0.03)。阳性 NRFS 与易激惹之间没有关联;因此,NRFS 对婴儿的气质没有影响。

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