Leppänen Marika, Korja Riikka, Rautava Päivi, Ahlqvist-Björkroth Sari
Department of Psychiatry and Public Health, University of Turku and Turku University Hospital, Turku, Finland.
Department of Psychology, University of Turku, Turku, Finland.
Front Psychol. 2024 Aug 7;15:1380826. doi: 10.3389/fpsyg.2024.1380826. eCollection 2024.
Early psychosocial interventions for preterm infants and their parents are diverse. This study aimed to structure the knowledge on psychosocial parent-infant interventions and to identify gaps in the intervention studies.
We included studies on early (during first year of life) psychosocial parent-infant interventions with parent-infant relationship outcomes after preterm birth (< 37 weeks). We excluded studies that did not focus on preterm infants, failed to indicate the studied intervention and outcomes, were not written in English, were not controlled or peer-reviewed studies, or did not provide essential information for eligibility. The search included studies published between January 2000 and March 2024 in PubMed and PsycINFO. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in reporting. Psychosocial parent-infant intervention studies were classified adapting the International Classification of Health Interventions (ICHI) and the Template for Intervention Description and Replication (TIDieR).
The included 22 studies reported data from 18 different interventions with preterm infants (< 37 weeks). Studies excluded preterm infants with health risks (19/22, 86%), with very low gestational age and/or birth weight (7/22, 32%), and/or mothers with psychosocial risks (14/22, 64%). Of the 18 interventions, 12 (67%) were classified as counseling, 3 (17%) as emotional support, 2 (11%) as psychotherapeutic, and 1 (6%) as educational. The parent-child relationship was assessed using 30 different methods and varying time points up to 18 months of age. Most studies (17/22, 77%) reported positive changes in the parent-child relationship favoring the intervention group.
We identified four types of interventions to influence parenting behavior; the most used was counseling. All four intervention types showed positive effects on parent-infant relationships, although the preterm populations studied were selective, the effects were evaluated using different methods, and the follow-up periods were short. These findings indicate a need for studies with standardized methods, longer follow-up, and less-restricted preterm populations to develop guidelines for all families with preterm infants.
针对早产儿及其父母的早期心理社会干预措施多种多样。本研究旨在梳理有关心理社会亲子干预的知识，并找出干预研究中的空白。
我们纳入了关于早产（<37周）后早期（出生后第一年）心理社会亲子干预及其亲子关系结果的研究。我们排除了那些未聚焦于早产儿、未指明所研究的干预措施和结果、非英文撰写、非对照或非同行评审的研究，或者未提供资格认定所需基本信息的研究。检索范围包括2000年1月至2024年3月在PubMed和PsycINFO上发表的研究。报告遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。心理社会亲子干预研究采用国际卫生干预分类（ICHI）和干预描述与复制模板（TIDieR）进行分类。
纳入的22项研究报告了来自18种不同的针对早产儿（<37周）干预措施的数据。研究排除了有健康风险的早产儿（19/22，86%）、极低胎龄和/或出生体重的早产儿（7/22，32%），以及/或者有心理社会风险的母亲（14/22，64%）。在这18种干预措施中，12种（67%）被归类为咨询，3种（17%）为情感支持，2种（11%）为心理治疗，1种（6%）为教育。使用30种不同方法和不同时间点（直至18个月龄）对亲子关系进行了评估。大多数研究（17/22，77%）报告干预组的亲子关系有积极变化。
我们确定了四种影响养育行为的干预类型；最常用的是咨询。尽管所研究的早产人群具有选择性，效果评估方法不同且随访期较短，但所有四种干预类型对亲子关系均显示出积极影响。这些发现表明需要开展采用标准化方法、更长随访期且对早产人群限制较少的研究，以制定适用于所有早产儿家庭的指南。
