Health Sciences, University of York, York, UK
Hull York Medical School, University of Hull, Hull, Kingston upon Hull, UK.
Arch Dis Child. 2021 Oct;106(10):987-993. doi: 10.1136/archdischild-2020-320655. Epub 2021 Mar 2.
This study aimed to quantify the incidence rates of common mental and physical health conditions in mothers of children with a life-limiting condition.
Comparative national longitudinal cohort study using linked primary and secondary care data from the Clinical Practice Research Datalink in England. Maternal-child dyads were identified in these data. Maternal physical and mental health outcomes were identified in the primary and secondary care datasets using previously developed diagnostic coding frameworks. Incidence rates of the outcomes were modelled using Poisson regression, adjusting for deprivation, ethnicity and age and accounting for time at risk.
A total of 35 683 mothers; 8950 had a child with a life-limiting condition, 8868 had a child with a chronic condition and 17 865 had a child with no long-term condition.The adjusted incidence rates of all of the physical and mental health conditions were significantly higher in the mothers of children with a life-limiting condition when compared with those mothers with a child with no long-term condition (eg, depression: incidence rate ratio (IRR) 1.21, 95% CI 1.13 to 1.30; cardiovascular disease: IRR 1.73, 95% CI 1.27 to 2.36; death in mothers: IRR 1.59, 95% CI 1.16 to 2.18).
This study clearly demonstrates the higher incidence rates of common and serious physical and mental health problems and death in mothers of children with a life-limiting condition. Further research is required to understand how best to support these mothers, but healthcare providers should consider how they can target this population to provide preventative and treatment services.
本研究旨在量化患有危及生命疾病儿童的母亲常见精神和身体健康状况的发病率。
使用英国临床实践研究数据链中的初级保健和二级保健的链接数据进行全国性的比较纵向队列研究。这些数据中确定了母婴对子。使用先前开发的诊断编码框架,在初级和二级保健数据集中确定了产妇的身体和精神健康结果。使用泊松回归对结果的发病率进行建模,调整了贫困、种族和年龄,并考虑了风险时间。
共 35683 位母亲;8950 位母亲的孩子患有危及生命的疾病,8868 位母亲的孩子患有慢性疾病,17865 位母亲的孩子没有长期疾病。与没有长期疾病的孩子的母亲相比,患有危及生命疾病的孩子的母亲所有身体和精神健康状况的调整发病率均显著更高(例如,抑郁症:发病率比(IRR)1.21,95%CI 1.13 至 1.30;心血管疾病:IRR 1.73,95%CI 1.27 至 2.36;母亲死亡:IRR 1.59,95%CI 1.16 至 2.18)。
本研究清楚地表明,患有危及生命疾病的儿童的母亲更常见且严重的身体和精神健康问题以及死亡的发病率更高。需要进一步研究以了解如何最好地支持这些母亲,但医疗保健提供者应考虑如何针对该人群提供预防和治疗服务。