Department of Psychiatry and Biobehavioral Sciences.
Department of Psychology, Stellenbosch University.
J Consult Clin Psychol. 2019 Jun;87(6):551-562. doi: 10.1037/ccp0000408.
This study examines the effect of a home visiting intervention on maternal alcohol use, problematic drinking, and the association of home visiting and alcohol use on children's behavioral, cognitive, and health outcomes at 5 time points over 5 years.
We analyzed 5,099 observations of 1,236 mothers and their children from pregnancy to 5 years postbirth, within a longitudinal cluster-randomized trial evaluating the effect of a home visiting intervention on mothers in Cape Town, South Africa. Paraprofessional home visitors coached mothers on coping with multiple risk factors, including a brief, 1-visit intervention on alcohol prevention in pregnancy. We assessed changes in maternal drinking over time in relation to the intervention, and then examined the impact of these drinking patterns on child outcomes over five years.
Drinking increased over the 5 years postbirth, but it was significantly lower in the intervention condition. Compared with abstinence, mothers' problematic drinking was associated with decreased child weight (-0.21 z-units) at all assessments, increased child aggressive behavior (3 to 7 additional symptoms), and decreased child performance on an executive functioning measure (the silly sounds task; odds ratio = .34) at 3 and 5 years. The intervention's effect was associated with increased child aggression (0.25 to 0.75 of 1 additional symptom), but the intervention appeared to decrease the effect of problem drinking on children's aggressive acts and executive functioning.
These findings support the need for sustained interventions to reduce alcohol use, especially for mothers who exhibit problematic drinking. Maternal drinking influences children's health and development over time. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
本研究考察了家访干预对产妇饮酒、问题饮酒的影响，以及家访与饮酒对儿童行为、认知和健康结果的关联，共在 5 年内的 5 个时间点进行了评估。
我们分析了南非开普敦一项纵向群组随机试验中 1236 名母亲及其子女的 5099 个观察值，该试验评估了家访干预对母亲的影响。准专业家访员指导母亲应对多种风险因素，包括针对孕期饮酒预防的 1 次简短家访干预。我们评估了母亲饮酒随时间的变化与干预的关系，然后考察了这些饮酒模式对 5 年内儿童结果的影响。
产后 5 年内饮酒量增加，但干预组明显较低。与戒酒相比，母亲的问题饮酒与所有评估中儿童体重下降（-0.21 z 单位）、儿童攻击行为增加（3 至 7 个额外症状）和儿童执行功能测试成绩下降（愚蠢声音任务；比值比=0.34）有关，3 岁和 5 岁时更为明显。干预的效果与儿童攻击行为增加有关（1 个额外症状增加 0.25 至 0.75），但干预似乎降低了问题饮酒对儿童攻击行为和执行功能的影响。
这些发现支持需要持续干预来减少饮酒，尤其是对表现出问题饮酒的母亲。母亲饮酒会影响儿童的健康和发育随时间的推移。
