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新生儿护理模式对中度和晚期早产儿18个月随访时神经发育的影响。

Effect of Model of Neonatal Care on Neurodevelopment at the 18 Month Follow-Up in Moderate and Late Preterm Infants.

作者信息

Benzies Karen M, Bartram Fiona C, McNeil Deborah A

机构信息

Faculty of Nursing and Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada.

Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada.

出版信息

J Clin Med. 2025 Jan 17;14(2):586. doi: 10.3390/jcm14020586.

DOI:10.3390/jcm14020586
PMID:39860593
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11766077/
Abstract

Preterm birth, even for moderate or late preterm infants (MLPIs), is associated with longer-term developmental challenges. Family Integrated Care (FICare) models of care, like Alberta FICare, aim to improve outcomes by integrating parents into neonatal care during hospitalization. This follow-up study examined the association between models of care (Alberta FICare versus standard care) and risk of child developmental delay at 18 months corrected age (CA) and explored the influences of maternal psychosocial distress. We assessed 257 mothers and 298 infants from a cluster randomized controlled trial (ID: NCT0279799) conducted in ten Level II NICUs in Alberta, Canada. Risk of delay was assessed using developmental screening tests. Maternal psychosocial distress was assessed using self-reported measures of depressive symptoms, anxiety, parenting stress, and self-efficacy. There was no association between model of care and risk of developmental delay. Higher maternal parenting stress was associated with increased risk of developmental delay. Alberta FICare was not associated with decreased risk of developmental delay at 18 months CA. Maternal parenting stress may play an important role in the development of MLPIs and should be addressed post-discharge.

摘要

早产,即使是中度或晚期早产儿(MLPIs),也与长期的发育挑战相关。家庭综合护理(FICare)模式,如艾伯塔省FICare,旨在通过在住院期间让父母参与新生儿护理来改善结局。这项随访研究考察了护理模式(艾伯塔省FICare与标准护理)与18个月矫正年龄(CA)时儿童发育迟缓风险之间的关联,并探讨了母亲心理社会困扰的影响。我们评估了来自加拿大艾伯塔省十个二级新生儿重症监护病房进行的一项整群随机对照试验(ID:NCT0279799)中的257名母亲和298名婴儿。使用发育筛查测试评估发育迟缓风险。使用自我报告的抑郁症状、焦虑、育儿压力和自我效能感测量方法评估母亲心理社会困扰。护理模式与发育迟缓风险之间没有关联。母亲较高的育儿压力与发育迟缓风险增加相关。艾伯塔省FICare与18个月CA时发育迟缓风险降低无关。母亲育儿压力可能在MLPIs的发育中起重要作用,出院后应予以关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/666e/11766077/7e98a9ed8413/jcm-14-00586-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/666e/11766077/8d97a0c67104/jcm-14-00586-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/666e/11766077/7e98a9ed8413/jcm-14-00586-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/666e/11766077/8d97a0c67104/jcm-14-00586-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/666e/11766077/7e98a9ed8413/jcm-14-00586-g002.jpg

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本文引用的文献

1
Overview of the Global and US Burden of Preterm Birth.全球及美国早产儿负担概述。
Clin Perinatol. 2024 Jun;51(2):301-311. doi: 10.1016/j.clp.2024.02.015. Epub 2024 Apr 4.
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Monitoring the Use of Human Milk, the Ideal Food for Very Low-Birth-Weight Infants-A Narrative Review.监测人乳的使用情况——极低出生体重儿的理想食物:一篇叙述性综述
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A systematic synthesis of qualitative studies on parents' experiences of participating in early intervention programs with their infant born preterm.一项关于父母参与早产婴儿早期干预项目经历的定性研究的系统综述。
Front Psychol. 2023 Jul 13;14:1172578. doi: 10.3389/fpsyg.2023.1172578. eCollection 2023.
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Maternal mental health and engagement in developmental care activities with preterm infants in the NICU.母亲的心理健康与早产儿在 NICU 中参与发展性护理活动。
J Perinatol. 2023 Jul;43(7):871-876. doi: 10.1038/s41372-023-01661-0. Epub 2023 Apr 12.
7
Creating Value Through Learning Health Systems: The Alberta Strategic Clinical Network Experience.通过学习型卫生系统创造价值:艾伯塔省战略临床网络的经验。
Nurs Adm Q. 2023;47(1):20-30. doi: 10.1097/NAQ.0000000000000552. Epub 2022 Nov 9.
8
The Role of Family Function and Triadic Interaction on Preterm Child Development-A Systematic Review.家庭功能和三元互动对早产儿童发育的作用——一项系统综述
Children (Basel). 2022 Nov 5;9(11):1695. doi: 10.3390/children9111695.
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Associations between symptoms of maternal postpartum depression, gestational age and infant social withdrawal: A longitudinal study in a community cohort.母婴产后抑郁症状、胎龄与婴儿社会退缩之间的关联:社区队列的纵向研究。
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Effects of Alberta Family Integrated Care (FICare) on Preterm Infant Development: Two Studies at 2 Months and between 6 and 24 Months Corrected Age.艾伯塔省家庭综合护理(FICare)对早产儿发育的影响:两项针对矫正年龄2个月及6至24个月婴儿的研究。
J Clin Med. 2022 Mar 18;11(6):1684. doi: 10.3390/jcm11061684.