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早产与产妇心理健康:纵向轨迹和预测因素。

Preterm Birth and Maternal Mental Health: Longitudinal Trajectories and Predictors.

机构信息

Murdoch Children's Research Institute.

Newborn Research, Royal Women's Hospital.

出版信息

J Pediatr Psychol. 2019 Jul 1;44(6):736-747. doi: 10.1093/jpepsy/jsz019.

DOI:10.1093/jpepsy/jsz019
PMID:30977828
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7967874/
Abstract

OBJECTIVE

To examine trajectories of psychological distress in mothers of children born very preterm (VPT, <30 weeks gestation) and full term from 2 to 13 years after the birth, and examine predictors of maternal psychological distress over time within the VPT group.

METHODS

Mothers of children born VPT (n = 159) and full term (n = 71) completed questionnaires assessing their psychological distress when their child was 2, 7, and 13 years of age. Mixed models were used to examine differences between groups in maternal psychological distress over time. Family social risk, child neonatal medial risk, child sex, multiple pregnancy, and child's neurodevelopmental impairment in early childhood were examined as potential predictors of maternal psychological distress within the VPT group.

RESULTS

Mothers of children born VPT displayed elevated psychological distress compared with mothers of full-term children, and this difference was consistent over time. Higher family social risk was associated with elevated maternal psychological distress throughout childhood across all time-points. There was evidence that mothers of children at higher neonatal medical risk displayed increasing psychological distress over time.

CONCLUSIONS

Mothers of children born VPT show prolonged psychological distress. Mothers from socially disadvantaged background and those whose child has neonatal medical complications may require extensive support to prevent prolonged psychological distress and promote optimal outcomes for children and families.

摘要

目的

探讨极早产儿(<30 周)和足月产儿母亲在出生后 2 至 13 年期间心理困扰的轨迹,并探讨极早产儿组中随时间变化的母亲心理困扰的预测因素。

方法

极早产儿(n=159)和足月产儿(n=71)的母亲在其孩子 2、7 和 13 岁时完成了评估其心理困扰的问卷。混合模型用于检验随时间变化两组之间母亲心理困扰的差异。家庭社会风险、新生儿医疗风险、儿童性别、多胎妊娠和儿童早期神经发育障碍被视为极早产儿组中母亲心理困扰的潜在预测因素。

结果

与足月产儿的母亲相比,极早产儿的母亲表现出更高的心理困扰,而且这种差异在整个时间内是一致的。较高的家庭社会风险与整个儿童时期所有时间点的母亲心理困扰升高有关。有证据表明,新生儿医疗风险较高的儿童的母亲心理困扰随时间增加。

结论

极早产儿的母亲表现出长期的心理困扰。来自社会劣势背景的母亲和其孩子有新生儿医疗并发症的母亲可能需要广泛的支持,以防止长期的心理困扰,并促进儿童和家庭的最佳结局。

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本文引用的文献

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Academic performance of children born preterm: a meta-analysis and meta-regression.早产儿儿童的学业表现:荟萃分析和荟萃回归。
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Very Preterm Birth and Parents' Quality of Life 27 Years Later.极早产儿出生 27 年后的父母生活质量。
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Impact of preterm birth on maternal well-being and women's perceptions of their baby: a population-based survey.早产对母亲幸福感及女性对其婴儿看法的影响:一项基于人群的调查。
BMJ Open. 2016 Oct 8;6(10):e012676. doi: 10.1136/bmjopen-2016-012676.
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Evolution of Depression and Anxiety Symptoms in Parents of Very Preterm Infants During the Newborn Period.新生儿期极早产儿父母抑郁和焦虑症状的演变。
JAMA Pediatr. 2016 Sep 1;170(9):863-70. doi: 10.1001/jamapediatrics.2016.0810.
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The influence of multiple birth and bereavement on maternal and family outcomes 2 and 7years after very preterm birth.极早产2年和7年后多胎妊娠及丧亲之痛对母亲及家庭结局的影响
Early Hum Dev. 2016 Sep;100:1-5. doi: 10.1016/j.earlhumdev.2016.04.005. Epub 2016 Jul 9.
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Late preterm birth is a strong predictor of maternal stress later in life: Retrospective cohort study in school-aged children.晚期早产是母亲晚年压力的有力预测指标:对学龄儿童的回顾性队列研究。
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Neurocognitive and Academic Outcomes at Age 10 Years of Extremely Preterm Newborns.极早早产儿10岁时的神经认知和学业成绩
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Risk of psychological distress in parents of preterm children in the first year: evidence from the UK Millennium Cohort Study.早产儿童父母第一年出现心理困扰的风险:来自英国千禧队列研究的证据。
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