Pan Chunhua, Gong Yong
Pediatric Department, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou, China.
Transl Pediatr. 2022 May;11(5):728-737. doi: 10.21037/tp-22-128.
A high-risk infant (HRI) is a child whose fetal, neonatal, and infant development is impacted by adverse factors that may cause cognitive, sensory, behavioral, or language defects. The complex situation in the treatment process is a continuous challenge and stressor for parents. If parents fail to take appropriate coping styles, it will have an adverse impact on the health of parents and the growth and development of children. The purpose of this study was to explore the impact of clinical characteristics, postpartum posttraumatic stress disorder (PTSD), and family coping on the neurodevelopment and language development of HRIs as a reference for targeted intervention.
This study retrospectively recruited 211 children who were hospitalized in the neonatal intensive care unit (NICU) of Suzhou Kowloon Hospital from January 2018 to December 2021. HRI and their mother were interviewed by telephone with general information questionnaire, Perinatal Post-traumatic Stress Disorder Questionnaire, medical coping modes questionnaire, Bayley Scales of Infant Development the Early Language Milestone Scale to investigate HRI and their mothers; Logistic regression was used to analyze the relationship between HRI mothers' emotions and family coping with neurodevelopment and language development.
The neurodevelopmental scores of HRIs differed according to gestational week of delivery, birth weight, and disease diagnosis. The language development scores of HRIs differed according to gestational week of delivery, birth weight, disease diagnosis, and maternal education. Multiple stepwise regression analysis showed that the neurodevelopmental scores were affected by gestational week of delivery, postpartum PTSD score, and family coping. Logistic regression analysis showed that the language development scores were affected by maternal education and neurodevelopmental level. The correlation analysis showed that the postpartum PTSD scores were negatively correlated with family coping, neurodevelopment, and language development, and that family coping was positively correlated with the neurodevelopment and language development scores (P<0.05).
The neurodevelopment and language development of HRIs were affected by the gestational week of delivery, maternal education, the child's birth weight, and disease diagnosis. NICU wards can promote the healthy development of HRIs by providing mothers with targeted health education concerning the child's condition, postpartum PTSD, and family coping strategies.
高危婴儿(HRI)是指其胎儿期、新生儿期及婴儿期发育受到可能导致认知、感官、行为或语言缺陷的不利因素影响的儿童。治疗过程中的复杂情况对父母来说是持续的挑战和压力源。如果父母未能采取适当的应对方式,将对父母的健康以及孩子的成长和发育产生不利影响。本研究的目的是探讨临床特征、产后创伤后应激障碍(PTSD)和家庭应对方式对高危婴儿神经发育和语言发育的影响,为针对性干预提供参考。
本研究回顾性招募了2018年1月至2021年12月在苏州九龙医院新生儿重症监护病房(NICU)住院的211名儿童。通过电话访谈高危婴儿及其母亲,使用一般信息问卷、围产期创伤后应激障碍问卷、医学应对方式问卷、贝利婴儿发育量表和早期语言里程碑量表对高危婴儿及其母亲进行调查;采用Logistic回归分析高危婴儿母亲的情绪和家庭应对方式与神经发育和语言发育之间的关系。
高危婴儿的神经发育得分因分娩孕周、出生体重和疾病诊断而异。高危婴儿的语言发育得分因分娩孕周、出生体重、疾病诊断和母亲教育程度而异。多元逐步回归分析显示,神经发育得分受分娩孕周、产后PTSD得分和家庭应对方式的影响。Logistic回归分析显示,语言发育得分受母亲教育程度和神经发育水平的影响。相关性分析显示,产后PTSD得分与家庭应对方式、神经发育和语言发育呈负相关,家庭应对方式与神经发育和语言发育得分呈正相关(P<0.05)。
高危婴儿的神经发育和语言发育受分娩孕周、母亲教育程度、孩子出生体重和疾病诊断影响。新生儿重症监护病房可以通过向母亲提供有关孩子病情、产后PTSD和家庭应对策略的针对性健康教育,促进高危婴儿的健康发育。