在COVID-19大流行之前和期间，对早产婴儿和参加过渡家庭计划的婴儿的孕产妇心理健康和急诊就诊。

IF 3.5 2区医学 Q1 PEDIATRICS

Journal of Pediatrics Pub Date : 2025-07-23 DOI:10.1016/j.jpeds.2025.114753

Julia Mayne MD , Katheleen Hawes PhD, RN , Elisabeth C. McGowan MD , Richard Tucker BA , Betty R. Vohr MD

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引用次数: 0

摘要

目的：探讨过渡家庭计划（THP）新生儿重症监护病房出院后1个月和3个月产妇心理健康（MMH）障碍与新生儿急诊（ED）就诊之间的关系。研究设计：回顾性分析在THP登记的公共保险新生儿重症监护病房（NICU）母婴双组队列。分组分为COVID-19大流行前（2017年1月1日- 2020年3月10日）和COVID-19大流行前（2020年3月11日- 2022年12月31日）。通过电话和面对面访问分析THP家庭、社会工作者和医务人员之间的联系，相对于急诊室访问和再住院。回归模型估计了MMH对急诊科就诊率的影响。结果：MMH紊乱率在不同时期呈上升趋势，但未达到显著性水平。不同时期的产妇特征相似，但COVID-19期间婴儿出生体重更高。总体而言，整个队列在COVID-19期间急诊科就诊次数减少。在COVID-19期间，整个队列的THP亲自访问减少，而电话联系保持不变。然而，对于在COVID-19期间就诊的婴儿，电话和面对面的THP就诊增加了。在回归模型中，MMH障碍与出院≤1个月急诊科就诊的几率较高相关（OR 2.34, CI 1.11-4.91）。结论：在整个研究期间，与没有MMH疾病的母亲所生的婴儿相比，患有MMH疾病的母亲所生的婴儿在出院后≤1个月的ED就诊次数更多。THP的工作人员增加了电话和面对面的联系，以支持那些在两个时期都有急诊科就诊的母婴。

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Maternal Mental Health and Emergency Department Visits for Infants Born Preterm and Enrolled in a Transition Home Program Before and During the COVID-19 Pandemic

Objective

To determine the association between maternal mental health (MMH) disorders before and during COVID-19 and infant emergency department (ED) visits 1- and 3-months post-NICU discharge among infants in a transition home program (THP).

Study design

Retrospective analysis of a publicly insured neonatal intensive care unit mother-infant dyad cohort enrolled in a THP. Groups were stratified to pre-COVID-19 pandemic (January 1, 2017-March 10, 2020) and COVID-19 pandemic (March 11, 2020-December 31, 2022). Contacts between THP families, social workers, and medical staff via phone and in-person visits were analyzed relative to ED visits and rehospitalizations. Regression models estimating effects of MMH on ED visit rates were examined.

Results

Rates of MMH disorders trended upwards between time periods but did not reach significance. Maternal characteristics were similar between time periods, yet infant birth weight was higher during COVID-19. Overall, ED visits decreased during COVID-19 for the total cohort. THP in-person visits for the total cohort decreased during COVID-19 whereas phone contacts remained unchanged. However, for infants with an ED visit during COVID-19, phone and in-person THP visits increased. In regression models, MMH disorder was associated with higher odds of ED visits ≤ 1 month of discharge (OR 2.34, 95% CI 1.11-4.91).

Conclusions

Over the entire study period, infants of mothers with MMH disorders had more ED visits ≤ 1 month of discharge compared with infants from women without a MMH disorder. THP staff responded with increased phone and in-person contacts to support mother-infant dyads for those who had an ED visit during both time periods.

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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.