The impact of extremely low birth weight on the families of school-aged children
The impact of extremely low birth weight on the families of school-aged children
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DOI：
10.1542/peds.2005-2118
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发表时间：
2006-06-01
期刊：
影响因子：
8
通讯作者：
Klein, Nancy
中科院分区：
文献类型：
--
作者：
Drotar, Dennis;Hack, Maureen;Klein, Nancy
objective.本研究的目的是通过一项对照研究，记录极低出生体重（<1000 g）对学龄儿童家庭的影响和负担以及相关问题。该研究还旨在记录极低出生体重组内家庭影响的个体差异的显着预测因素。一项前瞻性研究是在8年完成的一个队列的219名儿童出生极低出生体重1992年至1995年和176名儿童正常出生体重。测量包括以下预测变量：社会经济状况和父母风险，出生风险，新生儿风险，神经发育结果，适应能力受损，慢性疾病的功能影响。主要结果指标是对家庭规模的影响。家庭压力源和资源（生活压力源和社会资源清单）的措施也获得。主要发现是，与对照组相比，极低出生体重组的总家庭影响更大。此外，在经济影响、照顾者负担和家庭负担方面，极低出生体重组在特定领域对家庭的负面影响更大。这些差异并不归因于一般的家庭压力，社会经济地位，儿童，性别或种族。较高的父母/社会经济风险、神经发育结果和慢性疾病的功能影响预测极低出生体重组中更大的家庭影响，而出生和新生儿风险评分则没有。极低的出生体重与对家庭的负面影响有关。父母的社会经济风险，但最特别的是儿童相关的因素，如神经发育和慢性疾病的功能影响，预测的负面家庭的影响，在极低出生体重组。研究结果强调，需要制定和测试干预措施，为极低出生体重儿的家庭提供支持，以减轻极低出生体重和相关风险因素对家庭的负担。
OBJECTIVE. The purpose of this study was to document the impact and burden of extremely low birth weight (< 1000 g) and associated problems on the families of school-aged children in a controlled study. The study was also designed to document the salient predictors of individual differences of family impact within the extremely low birth weight group.METHODS. A prospective study was completed at 8 years of a cohort of 219 children with extremely low birth weight born 1992-1995 and 176 children with normal birth weight. Measures included the following predictor variables: socioeconomic status and parent risk, birth risk, neonatal risk, neurodevelopmental outcome, impairment in adaptive abilities, and functional impact of chronic conditions. The primary outcome measure was the Impact on Family scale. A measure of family stressors and resources (the Life Stressors and Social Resources Inventory) was also obtained.RESULTS. The primary finding was that the total family impact was greater in the extremely low birth weight group compared with controls. Moreover, the negative impact on family in specific domains was greater in the extremely low birth weight group in financial impact, caretaker burden, and familial burden. These differences were not attributable to general family stressors, socioeconomic status, child, gender, or race. Higher parent/socioeconomic risk, neurodevelopmental outcomes, and the functional impact of chronic conditions predicted greater family impact within the extremely low birth weight group, whereas birth and neonatal risk scores did not.CONCLUSIONS. Extremely low birth weight was associated with a negative impact on families. Socioeconomic parental risk, but most especially child-related factors such as neurodevelopmental and the functional impact of chronic conditions, predicted the negative family impact within the extremely low birth weight group. Findings underscore the need to develop and test interventions to provide support for families of extremely low birth weight infants to ameliorate the burden of extremely low birth weight and associated risk factors on families.