Chronic Disabling Fatigue at Age 13 and Association With Family Adversity
Chronic Disabling Fatigue at Age 13 and Association With Family Adversity
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DOI：
10.1542/peds.2011-2587
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发表时间：
2012-07-01
期刊：
影响因子：
8
通讯作者：
Sterne, Jonathan A. C.
中科院分区：
文献类型：
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作者：
Crawley, Esther;Hughes, Rachael;Sterne, Jonathan A. C.
目的：1)估计13岁时慢性致残疲劳的患病率；2)通过基于人群的出生队列研究，调查与早期家庭逆境的关系。方法：研究对象为10001名儿童，其中5657名在13岁时具有足够的数据来定义慢性致残性疲劳。慢性致残性疲劳被定义为母亲报告的疲劳，持续>= 3个月或>= 6个月，是致残性的（“相当多”或“大量”缺课或无法参加爱好/运动/休闲活动），而不是由于其他原因。家庭逆境是通过14个问题来定义的，这些问题涉及住房、教育、社会关系和出生时的产妇健康。我们使用多重imputation来校正患病率和随访损失的关联。结果：总体而言，1995名青少年在上个月感到疲劳，其中117名和53名患有慢性致残性疲劳，分别持续>= 3和>= 6个月。>= 3和>= 6个月的慢性致残疲劳患病率分别为2.07%和0.94%，但在输入缺失数据后分别增加到2.44%和1.30%。男孩和女孩的患病率相似。慢性致残疲劳的风险随着家庭逆境评分的增加而增加（>= 3和>= 6个月时，比值比分别为1.25[95%可信区间：1.09,1.43]和1.23[1.01,1.51]）。患有慢性致残性疲劳的儿童中，仅有36例（30.77%）咨询过医生。结论：慢性致残性疲劳在早期经历家庭逆境的家庭中更为常见，而且往往没有向卫生保健服务机构报告。儿科2012;130: e71-e79
OBJECTIVES: 1) Estimate the prevalence of chronic disabling fatigue at age 13, and 2) investigate associations with early family adversity, using a population-based birth cohort study.METHODS: The subjects were 10 001 children, of whom 5657 had sufficient data to define chronic disabling fatigue at age 13. Chronic disabling fatigue was defined as tiredness reported by mothers that had lasted for >= 3 months or >= 6 months, was disabling (school absence or prevented participation in hobbies/sport/leisure activities "quite a lot" or a "great deal"), and not due to another cause. Family adversity was defined by using 14 questions addressing housing, education, social relationships, and maternal health assessed prospectively at birth. We used multiple imputation to correct estimates of prevalence and association for loss to follow-up.RESULTS: Overall, 1995 teenagers had been tired for the last month, of whom 117 and 53 had chronic disabling fatigue of >= 3 and >= 6 months' duration, respectively. The estimated prevalence of chronic disabling fatigue of >= 3 and >= 6 months' duration was 2.07% and 0.94%, respectively, but increased to 2.44% and 1.30%, respectively, after imputing missing data. Prevalence was similar in boys and girls. The risk of chronic disabling fatigue increased with family adversity score (odds ratios: 1.25 [95% confidence interval: 1.09, 1.43] and 1.23 [1.01, 1.51] for >= 3 and >= 6 months' duration, respectively). Only 36 (30.77%) children with chronic disabling fatigue had consulted a doctor about their fatigue.CONCLUSIONS: Chronic disabling fatigue is more common in families who experienced early family adversity and is often not reported to health care services. Pediatrics 2012;130:e71-e79