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日本抚养3岁儿童困难的因素:地方政府积累的母婴健康信息的作用

Factors of Having Difficulties Raising 3-Year-Old Children in Japan: Usefulness of Maternal and Child Health Information Accumulated by the Local Government.

作者信息

Tagawa Kimiko, Tsunematsu Miwako, Kakehashi Masayuki

机构信息

Department of Health Informatics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan.

出版信息

Children (Basel). 2021 Nov 24;8(12):1084. doi: 10.3390/children8121084.

Abstract

Difficulties raising children may be associated with depressive tendencies and abuse by parents, for which maternal and child health information may be useful. We clarified factors related to difficulties in raising children at the time of the 3-year-old child health checkup. This was a retrospective cohort study. We used maternal and child health information collected from the time of pregnancy notification until the 3-year-old child health checkup. The subjects were the parents of 507 children who were born and eligible for the 3-year-old child health checkup between September 2013 and October 2017. Logistic regression and ROC analyses were performed. The dependent variable was "having difficulties raising children at the 3-year-old health checkup". Eleven factors were clarified as risk factors. Three major factors among them were having difficulties raising children at the 18-month-old checkup (adOR, 6.3; 95%CI, 3.0-13.9), actions are at the child's own pace and adult instructions are difficult to follow at the 18-month-old health checkup (adOR, 5.0; 95%CI, 1.3-25.4), and EPDS score ≥ 2 (adOR, 3.4; 95%CI, 1.5-8.1). The AUC of this predictive model was 0.86. At a cutoff value of 0.387, the sensitivity was 79.7% and the specificity was 77.6%. Having difficulties raising children at the 3-year-old health checkup has factors from the time of pregnancy and requires continued support. It was possible and useful to use maternal and child health information when screening high-risk parents.

摘要

抚养孩子困难可能与父母的抑郁倾向及虐待行为有关,母婴健康信息对此可能会有所帮助。我们明确了3岁儿童健康检查时与抚养孩子困难相关的因素。这是一项回顾性队列研究。我们使用了从怀孕告知时起至3岁儿童健康检查时收集的母婴健康信息。研究对象是2013年9月至2017年10月间出生且符合3岁儿童健康检查条件的507名儿童的父母。进行了逻辑回归和ROC分析。因变量是“在3岁健康检查时抚养孩子有困难”。明确了11个因素为风险因素。其中三个主要因素是在18个月检查时抚养孩子有困难(调整后比值比,6.3;95%置信区间,3.0 - 13.9)、在18个月健康检查时行为按孩子自己的节奏进行且难以遵循成人指令(调整后比值比,5.0;95%置信区间,1.3 - 25.4)以及爱丁堡产后抑郁量表(EPDS)评分≥2(调整后比值比,3.4;95%置信区间,1.5 - 8.1)。该预测模型的曲线下面积(AUC)为0.86。在临界值为0.387时,敏感性为79.7%,特异性为77.6%。在3岁健康检查时抚养孩子有困难存在孕期因素,需要持续的支持。在筛查高危父母时使用母婴健康信息是可行且有用的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ba6/8700700/de07cefb3bf6/children-08-01084-g001.jpg

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