Galling Britta, Brauer Hannah, Struck Pia, Krogmann Amanda, Gross-Hemmi Mirja, Prehn-Kristensen Alexander, Mudra Susanne
Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Institute of Child and Adolescent Psychiatry, Centre for Integrative Psychiatry, School of Medicine, University Medical Center Schleswig-Holstein - Campus Kiel, Kiel, Germany.
Front Child Adolesc Psychiatry. 2023 Feb 14;1:1099406. doi: 10.3389/frcha.2022.1099406. eCollection 2022.
There is increasing evidence that regulatory problems (RPs), such as excessive crying, sleeping or feeding problems in infancy, could be associated with the development of behavioral problems in childhood. In this meta-analysis we aimed to investigate the strength and characteristics of this association.
A systematic literature search (PubMed/PsycInfo, until 15/08/2021) for longitudinal prospective studies of infants with RPs and at least one follow-up assessment reporting incidence and/or severity of behavioral problems was conducted. The primary outcomes were (i) the cumulative incidence of behavioral problems in children (2-14 years) with previous RPs and (ii) the difference between children with/without previous RPs with regard to the incidence and severity of externalizing, internalizing and/or attention-deficit/hyperactivity disorder (ADHD) symptoms. Additionally, we analyzed behavioral problems of children with previous single, multiple or no RPs and with respect to age at follow-up. Subgroup and meta-regression analyses were added.
30 meta-analyzed studies reported on 34,582 participants (n= 5091, n= 29,491; age: baseline = 6.5 ± 4.5 months, follow-up = 5.5 ± 2.8 years) with excessive crying (studies = 13, = 1577), sleeping problems (studies = 9, = 2014), eating problems (studies = 3, = 105), any single (studies = 2, = 201) or multiple RPs (studies = 9, = 1194). The cumulative incidence for behavioral problems during childhood was 23.3% in children with RPs. Behavioral problems were significantly more pronounced in infants with RPs compared to healthy controls (SMD = 0.381, 95% CI = 0.296-0.466, < .001), particularly with multiple RPs (SMD = 0.291, = 0.018).
Findings suggest that RPs in infancy are associated with overall behavioral problems (externalizing or internalizing behavior and ADHD symptoms) in childhood. Our data cannot explain linked developmental trajectories and underlying factors. However, detection of affected infants may help to adapt supportive measures to the individual familial needs to promote the parent-child-relationship and prevent the development of child behavioral problems from early on.
越来越多的证据表明，调节问题（RPs），如婴儿期过度哭闹、睡眠或喂养问题，可能与儿童期行为问题的发展有关。在这项荟萃分析中，我们旨在研究这种关联的强度和特征。
对患有RPs的婴儿进行纵向前瞻性研究，并进行至少一次随访评估，报告行为问题的发生率和/或严重程度，进行系统的文献检索（截至2021年8月15日的PubMed/PsycInfo）。主要结果是：（i）有既往RPs的儿童（2至14岁）行为问题的累积发生率；（ii）有/无既往RPs的儿童在外化、内化和/或注意力缺陷多动障碍（ADHD）症状的发生率和严重程度方面的差异。此外，我们分析了有既往单一、多个或无RPs的儿童以及随访时年龄方面的行为问题。增加了亚组分析和元回归分析。
30项荟萃分析研究报告了34582名参与者（n = 5091，n = 29491；年龄：基线 = 6.5 ± 4.5个月，随访 = 5.5 ± 2.8岁），包括过度哭闹（研究 = 13，n = 1577）、睡眠问题（研究 = 9, n = 2014）、进食问题（研究 = 3, n = 105）、任何单一（研究 = 2, n = 201）或多个RPs（研究 = 9, n = 1194）。有RPs的儿童在童年期行为问题的累积发生率为23.3%。与健康对照组相比，有RPs的婴儿行为问题明显更突出（标准化均数差[SMD] = 0.381，95%置信区间[CI] = 0.296 - 0.466，P <.001），特别是有多个RPs的情况（SMD = 0.291，P = 0.018）。
研究结果表明，婴儿期的RPs与儿童期的整体行为问题（外化或内化行为以及ADHD症状）有关。我们的数据无法解释相关的发展轨迹和潜在因素。然而，对受影响婴儿的检测可能有助于根据个体家庭需求调整支持措施，以促进亲子关系，并从早期预防儿童行为问题的发展。
