Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 157-8535, Japan.
Shizuoka Graduate University of Public Health, 4-27-2 Kita-Ando, Aoi-Ku, Shizuoka-Shi, 420-0881, Japan.
Health Qual Life Outcomes. 2023 Jul 10;21(1):68. doi: 10.1186/s12955-023-02156-4.
The level of child development may be associated with the risk of poor maternal health-related quality of life (HRQoL). The objective of this study was to describe the developmental characteristics of very low birth weight (VLBW) children at 2.5 years of age and to examine associations between maternal HRQoL and the degree of child development based on the Japanese version of Ages and Stages Questionnaire (J-ASQ-3).
A cross-sectional study was performed using the data from a nationwide prospective birth cohort study in Japan. Among a total of 104,062 fetal records, the VLBW infants (birth weight ≤ 1500 g) were analyzed using linear regression models, adjusted for potential covariates. Subgroup analysis was also conducted to assess the association between social connection or cooperation of the partner and maternal HRQoL by the level of child development.
The final study subjects included 357 VLBW children and mothers. The suspected developmental delays (SDDs) in at least two domains was significantly associated with lower maternal mental HRQoL regression coefficient -2.314 (95%CI: -4.065 to -0.564). There was no association between the status of child development and maternal physical HRQoL. After adjusting for child and maternal covariates, the maternal HRQoL was not significantly associated with child development. Amongst women who indicated having some social support, having a child with a SDD in two or more domains was negatively associated with mental HRQoL compared with women whose child was less developmental delay, regression coefficient -2.337 (95%CI: -3.961 to -0.714). Amongst women who indicated having partner's cooperation to child-rearing, having a child with a SDD in two or more domains was negatively associated with mental HRQoL compared with women whose child was less developmental delay, regression coefficient -3.785 (95%CI: -6.647 to -0.924).
Our findings indicate that the lower maternal mental HRQoL was independently associated with the SDDs evaluated by the J-ASQ-3, whereas there was no association after adjusting for covariates. Further research is warranted to elucidate the impact of social connection and partner's cooperation on maternal HRQoL and child development. This study urges that particular attention should be paid to mothers of VLBW children with SDDs and also to provide early intervention and continued support.
儿童的发育水平可能与产妇健康相关生活质量（HRQoL）不良的风险相关。本研究的目的是描述极低出生体重（VLBW）儿童在 2.5 岁时的发育特征，并根据日本版年龄与阶段问卷（J-ASQ-3）检查母亲 HRQoL 与儿童发育程度之间的关联。
本研究使用了来自日本全国前瞻性出生队列研究的数据进行了横断面研究。在总共 104062 个胎儿记录中，使用线性回归模型对 VLBW 婴儿（出生体重≤1500g）进行了分析，并对潜在的协变量进行了调整。还进行了亚组分析，以评估社会联系或伴侣合作与母亲 HRQoL 之间的关联，其关联的依据是儿童的发育水平。
最终研究对象包括 357 名 VLBW 婴儿及其母亲。至少有两个领域存在发育迟缓（SDD）的情况与母亲心理 HRQoL 显著相关（回归系数-2.314，95%CI：-4.065 至-0.564）。儿童发育状况与母亲的生理 HRQoL 无关。在调整了儿童和母亲的协变量后，母亲的 HRQoL 与儿童的发育情况无明显关联。在表示有一定社会支持的女性中，与儿童在两个或更多领域存在 SDD 的女性相比，儿童在两个或更多领域存在发育迟缓的女性心理 HRQoL 较低，回归系数-2.337（95%CI：-3.961 至-0.714）。在表示有伴侣合作育儿的女性中，与儿童在两个或更多领域存在 SDD 的女性相比，儿童在两个或更多领域存在发育迟缓的女性心理 HRQoL 较低，回归系数-3.785（95%CI：-6.647 至-0.924）。
我们的研究结果表明，较低的母亲心理 HRQoL 与 J-ASQ-3 评估的 SDD 独立相关，而在调整了协变量后，两者没有关联。需要进一步研究阐明社会联系和伴侣合作对母亲 HRQoL 和儿童发育的影响。本研究呼吁特别关注有 SDD 的 VLBW 儿童的母亲，并提供早期干预和持续支持。
