Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia.
J Epidemiol Community Health. 2019 May;73(5):393-400. doi: 10.1136/jech-2018-210992. Epub 2019 Feb 21.
Currently, there is mixed evidence regarding the effects on children when a parent is chronically ill. Research has also primarily been conducted with adolescent samples. This study investigated developmental vulnerabilities in young children of parents with chronic illness.
This study used linked administrative data. The study population included children born in Western Australia during 2003-2004 (n=19 071; mean age 5.5 years). The outcome measure was a score in the bottom 25% on any of the five developmental domains (physical, social, emotional, communicative and cognitive) of the Australian Early Development Census (2009 collection). Parental chronic illnesses were identified from hospital and cancer registry records, during the period from 1 year prior to the child's birth and until the end of 2009.
Higher odds of developmental vulnerabilities in physical, social, emotional and communication domains were observed for daughters of chronically ill mothers. Sons of chronically ill mothers had increased odds of language and cognitive difficulties. Risk level increased with each additional year of exposure to maternal chronic illness. Results also indicated increased odds of developmental vulnerabilities for children of mothers experiencing multiple compared with single chronic conditions; however, results were not statistically significant (all p>0.05). No association between fathers' chronic illness and children's developmental outcomes was found.
Maternal chronic illness is associated with an increased risk of poor developmental outcomes for children, particularly daughters. Healthcare services have an important role to play in linking families into appropriate family-centred services to best support the needs of chronically ill mothers.
目前,关于父母长期患病对儿童的影响,证据不一。研究主要针对青少年样本进行。本研究调查了患有慢性疾病的父母的幼儿的发育脆弱性。
本研究使用了关联的行政数据。研究人群包括 2003-2004 年在西澳大利亚出生的儿童(n=19071;平均年龄 5.5 岁)。结局指标是澳大利亚早期发展普查(2009 年收集)的五个发展领域(身体、社会、情感、沟通和认知)中任何一个领域的得分处于底部的 25%。从孩子出生前一年到 2009 年底,从医院和癌症登记处的记录中确定了父母的慢性疾病。
患有慢性疾病的母亲的女儿在身体、社会、情感和沟通领域出现发育脆弱性的几率较高。患有慢性疾病的母亲的儿子出现语言和认知困难的几率增加。随着母亲慢性疾病暴露年限的增加,风险水平增加。结果还表明,与仅患有一种慢性疾病的母亲相比,患有多种慢性疾病的母亲的孩子出现发育脆弱性的几率增加,但无统计学意义(均 p>0.05)。未发现父亲的慢性疾病与儿童发育结果之间存在关联。
母亲的慢性疾病与儿童发育不良的风险增加有关,尤其是女儿。医疗保健服务机构在将家庭联系到适当的以家庭为中心的服务中发挥着重要作用,以最好地满足慢性疾病母亲的需求。