Associations between problems with crying, sleeping and/or feeding in infancy and long-term behavioural outcomes in childhood: a meta-analysis
Associations between problems with crying, sleeping and/or feeding in infancy and long-term behavioural outcomes in childhood: a meta-analysis
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DOI：
10.1136/adc.2010.191312
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发表时间：
2011-07-01
影响因子：
5.2
通讯作者：
Schneider, Silvia
中科院分区：
文献类型：
--
作者：
Hemmi, Mirja Helen;Wolke, Dieter;Schneider, Silvia
方法对1987-2006年间进行的22项纵向研究进行Meta分析，检验婴儿调节问题与儿童内化、外化和注意缺陷/多动障碍(ADHD)问题的关系；对1935名有调节问题的儿童进行测试。科恩的d被用来表达监管问题和行为问题之间的联系。使用I2统计量评估效应大小的异质性，并进行方差和元回归的Meta分析以评估调节因素的影响。结果主要调节问题-行为问题关联的加权平均效应大小为0.41(95%可信区间0.28~0.54)，表明既往存在调节问题的儿童比对照组更易出现行为问题。外部化和ADHD问题是所有监管问题中最强烈的结果，故障安全N值最高，样本量与效应量的相关性最低。方差的Meta分析显示，监管问题共病(i-2=44.0，p>；0.05)、类型(i-2=41.8，p>；0.05)或持续时间(i-2=44.0，p>；0.05)没有显著的缓和影响。结论元分析表明，既往有管教问题的儿童比对照儿童有更多的行为问题，尤其是在多问题家庭中。需要进一步的研究来评估以前睡眠、进食或多次受扰的儿童的行为结果。
Background Excessive crying, sleeping or feeding problems are found in approximately 20% of infants and may predict behavioural problems in childhood.Methods A quantitative meta-analysis of 22 longitudinal studies from 1987 to 2006 that statistically tested the association between infant regulatory problems and childhood internalising, externalising and attention-deficit/hyperactivity disorder (ADHD) problems was carried out; 1935 children with regulatory problems were tested. Cohen's d was used to express the association between regulatory problems and behavioural problems. Heterogeneity of the effect sizes was assessed using the I 2 statistic and meta-analysis of variance and meta-regressions were conducted to assess the influence of moderators. Rosenthal's classic fail-safe N and correlation of sample sizes to effect sizes were used to assess publication bias.Results The weighted mean effect size for the main regulatory problems-behavioural problems association was 0.41 (95% CI 0.28 to 0.54), indicating that children with previous regulatory problems have more behavioural problems than controls. Externalising and ADHD problems were the strongest outcome of any regulatory problem, indicated by the highest fail-safe N and lowest correlation of sample size to effect size. Meta-analyses of variance revealed no significant moderating influences of regulatory problem comorbidity (I-2 = 44.0, p > 0.05), type (I-2 = 41.8, p > 0.05) or duration (I-2 = 44.0, p > 0.05). However, cumulative problems and clinical referral increased the risk of behavioural problems.Conclusions The meta-analyses suggest that children with previous regulatory problems have more behavioural problems than controls, particularly in multi-problem families. Further studies are required to assess the behavioural outcomes of previously sleep, feeding or multiply disturbed children.