Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W29, 20246 Hamburg, Germany.
Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W29, 20246 Hamburg, Germany.
J Affect Disord. 2019 Mar 1;246:74-81. doi: 10.1016/j.jad.2018.12.025. Epub 2018 Dec 17.
Preterm births rates of infants with very low birth weight (VLBW < 1500 g) are increasing. Prematurity poses several risks for emotional child development, e.g., internalizing symptoms. Our understanding of this condition in young children is limited, for at preschool age, symptoms have mostly been assessed from the mother's perspective only.
As part of the longitudinal HaFEn cohort-study in Hamburg, Germany, we measured the level of internalizing symptoms in VLBW and term preschoolers as well as predictors from four informants' perspectives: mother, father, teacher, and child. A multilevel model was constructed to examine predictors of internalizing symptoms. n = 104 VLBW and n = 79 term children were included.
From both their parents' perspective, children with VLBW had a significantly higher level of internalizing symptoms. From the teacher's and child's own perspectives, there were no significant mean group differences. In the multilevel analyses, the results were different regarding the four perspectives. VLBW did not predict internalizing symptoms. From mother's perspective, her own postpartum psychological distress, and from father's perspective, his postpartum and current psychological distress predicted a higher level of internalizing symptoms in their offspring. From teacher's perspective, socio-economic status predicted internalizing symptoms.
The sample size was relatively small. Exclusion criteria and drop out of families could have created some selection bias.
Our findings point to the importance of early identification of parental postpartum psychological distress given the potential for later internalizing symptoms in their children or the perception of their offspring as vulnerable and symptomatic, which may also impact the child's development.
极低出生体重儿（VLBW < 1500 克）的早产儿出生率正在上升。早产会给儿童的情绪发展带来多种风险，例如内化症状。我们对幼儿期这种情况的了解有限，因为在学龄前，症状主要是从母亲的角度评估的。
作为德国汉堡 HaFEn 纵向队列研究的一部分，我们测量了 VLBW 和足月学龄前儿童内化症状的水平，以及来自四个信息提供者（母亲、父亲、教师和儿童）角度的预测因素。构建了一个多层次模型来检查内化症状的预测因素。共纳入 104 名 VLBW 和 79 名足月儿童。
从父母双方的角度来看，VLBW 儿童的内化症状水平明显更高。从教师和儿童自身的角度来看，两组之间没有显著的平均差异。在多层次分析中，四个角度的结果不同。VLBW 并不预测内化症状。从母亲的角度来看，她自己的产后心理困扰，以及从父亲的角度来看，他的产后和当前的心理困扰，都预示着他们的后代会有更高水平的内化症状。从教师的角度来看，社会经济地位预测了内化症状。
样本量相对较小。排除标准和家庭的退出可能会造成一些选择偏差。
我们的研究结果表明，鉴于父母产后心理困扰可能导致子女日后出现内化症状，或者父母认为子女脆弱和出现症状，这可能也会影响儿童的发展，因此早期识别父母产后心理困扰非常重要。
