Department of Epidemiology, Lazio Regional Health Service-ASL ROMA1, Rome, Italy.
Center for Behavioral Science and Mental Health, Istituto Superiore di Sanità, Rome, Italy.
PLoS One. 2022 Oct 3;17(10):e0275521. doi: 10.1371/journal.pone.0275521. eCollection 2022.
Unintentional injuries such as falls, are particularly frequent in early childhood. To date, epidemiological studies in this field have been carried out using routine data sources or registries and many studies were observational studies with a cross-sectional design. The aims of the study are to describe unintentional injuries in the first two years of life in the Piccolipiù birth cohort, and to investigate the association between mother and children characteristics and the First Event of Raised surface Fall (FERF).
This longitudinal observational study included 3038 children from an Italian birth cohort. Data on socio-demographic factors, socio-economic indicators, maternal health and lifestyle characteristics and child's sleeping behavior, obtained from questionnaires completed at birth, 12 and 24 months of age, were considered in the analyses as potential risk factors of FERF. Time of occurrence of FERF was analyzed using the Kaplan-Meier method. The multivariable analysis for time to event was carried out using a Cox proportional hazards model.
Falls from raised surfaces are the leading cause of unintentional injuries in the cohort with 610 (21.1%) and 577 (20.0%) cases among children during the first and second year of life, respectively. An increased risk of FERF was associated with several risk factors: maternal psychological distress (HR 1.41, 95%CI 1.10-1.81), maternal alcohol intake (HR 1.26, 95%CI 1.10-1.45), and child's sleeping problems (HR 1.28, 95%CI 1.09-1.51). Children with older aged mothers (HR 0.98, 95%CI 0.96-0.99) and living in northern Italy (HR 0.64, 95%CI 0.55-0.75) had a lower risk of FERF.
The results of the study suggest that a higher risk of FERF is associated with socio-demographic factors, maternal characteristics and child sleeping behavior that could hinder parent empowerment.
意外伤害,如跌倒,在幼儿中尤为常见。迄今为止,该领域的流行病学研究都是使用常规数据源或登记处进行的,许多研究都是具有横断面设计的观察性研究。本研究的目的是描述 Piccolipiù 出生队列中生命头两年的意外伤害,并调查母亲和儿童特征与首次高处坠落事件(First Event of Raised surface Fall,FERF)之间的关联。
本纵向观察性研究纳入了来自意大利出生队列的 3038 名儿童。在分析中考虑了从出生、12 个月和 24 个月时完成的问卷中获得的社会人口因素、社会经济指标、母亲健康和生活方式特征以及儿童睡眠行为等数据,这些数据被认为是 FERF 的潜在危险因素。使用 Kaplan-Meier 方法分析 FERF 的发生时间。使用 Cox 比例风险模型对事件时间的多变量分析进行了分析。
从高处坠落是该队列中意外伤害的主要原因,在生命的头一年和第二年分别有 610(21.1%)和 577(20.0%)例。FERF 的风险增加与多个危险因素相关:母亲心理困扰(HR 1.41,95%CI 1.10-1.81)、母亲饮酒(HR 1.26,95%CI 1.10-1.45)和儿童睡眠问题(HR 1.28,95%CI 1.09-1.51)。年龄较大的母亲(HR 0.98,95%CI 0.96-0.99)和居住在意大利北部的儿童(HR 0.64,95%CI 0.55-0.75)FERF 的风险较低。
研究结果表明,FERF 的风险增加与社会人口因素、母亲特征和儿童睡眠行为相关,这可能会阻碍父母的赋权。