Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, Singapore, 119228, Singapore.
BMC Pediatr. 2019 Aug 16;19(1):286. doi: 10.1186/s12887-019-1651-z.
Although infant media exposure has received attention for its implications on child development, upstream risk factors contributing to media exposure have rarely been explored. The study aim was to examine the relationship between maternal risk factors, infant television (TV) viewing, and later child cognition.
We used a prospective population-based birth cohort study, Growing Up in Singapore Towards healthy Outcomes (GUSTO), with 1247 pregnant mothers recruited in their first trimester. We first explored the relationship of infant TV exposure at 12 months and the composite IQ score at 4.5 years, as measured by the Kaufman Brief Intelligence Test, Second Edition (KBIT-2). Multivariable linear regressions were adjusted for maternal education, maternal mental health, child variables, birth parameters, and other relevant confounders. We then examined the associations of maternal risk factors with the amount of daily TV viewing of 12-month-old infants. Path analysis followed, to test a conceptual model designed a priori to test our hypotheses.
The average amount of TV viewing at 12 months was 2.0 h/day (SD 1.9). TV viewing in hours per day was a significant exposure variable for composite IQ (ß = - 1.55; 95% CI: - 2.81 to - 0.28) and verbal IQ (ß = - 1.77; 95% CI: - 3.22 to - 0.32) at 4.5 years. Our path analysis demonstrated that lower maternal education and worse maternal mood (standardized ß = - 0.27 and 0.14, respectively, p < 0.01 for both variables) were both risk factors for more media exposure. This path analysis also showed that maternal mood and infant TV strongly mediated the relationship between maternal education and child cognition, with an exceptional model fit (CFI > 0.99, AIC 15249.82, RMSEA < 0.001).
Infant TV exposure has a negative association with later cognition. Lower maternal education and suboptimal maternal mental health are risk factors for greater television viewing. Paediatricians have a role in considering and addressing early risks that may encourage television viewing.
尽管婴儿接触媒体对其儿童发展有影响，但很少有研究探讨导致婴儿接触媒体的上游风险因素。本研究旨在探讨母亲的风险因素、婴儿看电视和以后儿童认知之间的关系。
我们使用了一项前瞻性基于人群的出生队列研究，即新加坡健康儿童成长研究（GUSTO），在妊娠的第一个三个月招募了 1247 名孕妇。我们首先探讨了婴儿在 12 个月时的电视暴露情况与 4.5 岁时的综合智商得分之间的关系，综合智商得分通过 Kaufman 简明智力测验第二版（KBIT-2）进行测量。多变量线性回归调整了母亲的教育程度、母亲的心理健康状况、儿童变量、出生参数和其他相关混杂因素。然后，我们检查了母亲的风险因素与 12 个月大婴儿每天看电视时间的关系。然后进行路径分析，以检验我们事先设计的概念模型来检验我们的假设。
平均每天的电视观看时间为 2.0 小时（SD 1.9）。每天看电视的时间是 4.5 岁时综合智商（ß= -1.55；95%置信区间：-2.81 至-0.28）和言语智商（ß= -1.77；95%置信区间：-3.22 至-0.32）的显著暴露变量。我们的路径分析表明，较低的母亲教育程度和较差的母亲情绪（标准化ß分别为-0.27 和 0.14，两者均为 p<0.01）都是更多媒体暴露的风险因素。该路径分析还表明，母亲情绪和婴儿看电视行为强烈中介了母亲教育程度与儿童认知之间的关系，模型拟合度极好（CFI>0.99，AIC 15249.82，RMSEA<0.001）。
婴儿看电视与以后的认知能力呈负相关。较低的母亲教育程度和较差的母亲心理健康是婴儿看电视更多的风险因素。儿科医生在考虑和解决可能鼓励婴儿看电视的早期风险方面发挥作用。
