极早产儿的不良童年经历和社会情感结果。

IF 3.9 2区医学 Q1 PEDIATRICS

Journal of Pediatrics Pub Date : 2024-10-21 DOI:10.1016/j.jpeds.2024.114377

Callie L. Bishop MD , Rachel E. Lean PhD , Tara A. Smyser MSE , Christopher D. Smyser MD , Cynthia E. Rogers MD

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引用次数: 0

摘要

目的：研究不良童年经历（ACE）是否会导致早产儿出现社会情感问题：研究设计：作为一项纵向研究的一部分，从一家三级新生儿重症监护病房招募了 96 名妊娠 23-30 周的早产儿，并对他们进行了 2 岁和 5 岁的随访。从邻近的产科服务机构和当地社区招募了 83 名足月（FT，妊娠 37-41 周）儿童。2 岁时使用儿童生活事件量表对 ACE 进行评估，5 岁时使用学龄前儿童精神病学评估对 ACE 进行评估。5岁时，分别使用儿童行为检查表（Child Behavior Checklist）和康纳尔评定量表（Conner's Rating Scale-Revised）对内化、外化和注意力缺陷/多动障碍（ADHD）症状进行评估。在 2 年和/或 5 年的随访中，对包括社会经济劣势、母亲痛苦和父母多动症症状在内的协变量进行了评估。在考虑家庭聚类的情况下，对出生组别、ACE和社会情感结果之间的关联进行了中介和调节分析：结果：经协变量调整后，VPT出生的儿童经历了更多的ACEs（p结论：儿童ACEs筛查应在儿童期进行：儿童 ACE 筛查应纳入对 VPT 出生儿童及其家庭的后续护理中。筛查和解决父母社会心理功能问题的策略可能对支持儿童的社会情感发展非常重要。

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Adverse Childhood Experiences and Socioemotional Outcomes of Children Born Very Preterm

Objective

To examine whether adverse childhood experiences (ACEs) confer risk for socioemotional problems in children born very preterm (VPT).

Study design

As part of a longitudinal study, 96 infants born VPT at 23-30 weeks of gestation were recruited from a level III neonatal intensive care unit and underwent follow-up at ages 2 and 5 years. Eighty-three full-term (FT) (37-41 weeks gestation) children were recruited from an adjoining obstetric service and the local community. ACEs were assessed with the Child Life Events Scale at age 2 and Preschool Age Psychiatric Assessment at age 5. At age 5, internalizing, externalizing, and attention deficit hyperactivity disorder (ADHD) symptoms were assessed with the Child Behavior Checklist and Conner's Rating Scale-Revised, respectively. Covariates including socioeconomic disadvantage, maternal distress, and parent ADHD symptoms were assessed at the 2- and/or 5-year follow-up. Mediation and moderation analysis, accounting for family clustering, examined associations between birth group, ACEs, and socioemotional outcomes.

Results

After covariate adjustment, children born VPT experienced more ACEs (P < .001), particularly medical ACEs (P < .01), and had worse ADHD and internalizing outcomes (P < .05) than full-term children. ACEs mediated the association between birth group and ADHD outcomes (95% CI, 0.11-4.08). There was no evidence of mediation for internalizing outcomes. Higher parent ADHD symptoms (P < .001) and maternal distress (P < .05) were associated with poorer internalizing outcomes.

Conclusions

Screening for childhood ACEs should be embedded in the follow-up care of children born VPT and their families. Strategies to screen for and address parent psychosocial functioning may be important to support children's socioemotional development.

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来源期刊

Journal of Pediatrics 医学-小儿科

CiteScore

6.00

自引率

2.00%

发文量

696

审稿时长

31 days

期刊介绍： The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy. Topics covered in The Journal of Pediatrics include, but are not limited to: General Pediatrics Pediatric Subspecialties Adolescent Medicine Allergy and Immunology Cardiology Critical Care Medicine Developmental-Behavioral Medicine Endocrinology Gastroenterology Hematology-Oncology Infectious Diseases Neonatal-Perinatal Medicine Nephrology Neurology Emergency Medicine Pulmonology Rheumatology Genetics Ethics Health Service Research Pediatric Hospitalist Medicine.