父母压力与父母喂养行为和喂养方式之间的关系:观察性研究的系统评价和荟萃分析。

The association between parents' stress and parental feeding practices and feeding styles: Systematic review and meta-analysis of observational studies.

机构信息

Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.

Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.

出版信息

Matern Child Nutr. 2023 Jan;19(1):e13448. doi: 10.1111/mcn.13448. Epub 2022 Oct 25.

Abstract

In the extended UNICEF framework of early childhood nutrition, parents' stress is associated with parental feeding style. However, no comprehensive review has examined the association between parents' stress and feeding styles and practices. The objective of our review was to synthesise the current literature examining the association between parents' stress and their feeding practices and/or styles, among parents of children ≤ 5 years old. We searched; MEDLINE, EMBASE, PSYCHINFO and CINAHL from 2019 to 2021. Two investigators independently extracted relevant data and assessed the study quality and the certainty of evidence. Data were pooled using generic inverse variance with fixed effects (<5 comparisons) or random effects (≥5 comparisons) and expressed as correlation coefficients with 95% confidence intervals (CI). Between study heterogeneity was assessed using Cochran's Q and quantified with I . We identified 6 longitudinal and 11 cross-sectional studies, of which 4 studies provided sufficient data to be pooled. A very small correlation between general stress and restrictive feeding practices was observed (r = 0.06 [95% CI: 0.01-0.12]; no substantial heterogeneity (I  = 0.00%, P  < 0.85, very low certainty). No correlation between general stress and feeding pressure was identified (r = 0.06 [95% CI: -0.02 to 0.15]). Results showed that both general and parenting stress were associated with suboptimal breastfeeding practices and unresponsive feeding styles. Conclusion: This study demonstrated a low-to-moderate quality of literature for the inclusion of parents' stress in the extended UNICEF care model of child nutrition. Future research needs to explore this relationship longitudinally and in ethnic diverse populations to inform tailored interventions that promote responsive feeding practices.

摘要

在儿童期营养的扩展 UNICEF 框架中,父母的压力与父母的喂养方式有关。然而,尚无综合审查研究考察父母的压力与喂养方式和行为之间的关系。我们的综述目的是综合当前文献,检查父母的压力与父母在 5 岁以下儿童中的喂养行为和/或方式之间的关系。我们在 2019 年至 2021 年期间在 MEDLINE、EMBASE、PSYCHINFO 和 CINAHL 上进行了搜索。两名调查员独立提取了相关数据,并评估了研究质量和证据的确定性。使用固定效应(<5 个比较)或随机效应(≥5 个比较)的通用倒数方差对数据进行汇总,并以 95%置信区间(CI)表示相关系数。使用 Cochran's Q 评估研究之间的异质性,并以 I²表示。我们确定了 6 项纵向研究和 11 项横断面研究,其中 4 项研究提供了足够的数据进行汇总。一般压力与限制喂养行为之间观察到很小的相关性(r=0.06[95%CI:0.01-0.12];没有实质性异质性(I²=0.00%,P<0.85,极低确定性)。未发现一般压力与喂养压力之间存在相关性(r=0.06[95%CI:-0.02 至 0.15])。结果表明,一般压力和育儿压力都与不适当的母乳喂养行为和无反应的喂养方式有关。结论:这项研究表明,纳入父母的压力对 UNICEF 儿童营养扩展照护模式的文献质量低至中等。未来的研究需要在不同族裔群体中进行纵向研究,以探索这种关系,为促进响应性喂养行为的有针对性的干预措施提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5938/9749598/e1461c6c685e/MCN-19-e13448-g002.jpg

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