Patterns of Medical and Developmental Comorbidities Among Children Presenting With Feeding Problems: A Latent Class Analysis
Patterns of Medical and Developmental Comorbidities Among Children Presenting With Feeding Problems: A Latent Class Analysis
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DOI：
10.1097/dbp.0b013e318203e06d
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发表时间：
2011-01-01
影响因子：
2.4
通讯作者：
LeLeiko, Neal S.
中科院分区：
文献类型：
--
作者：
Berlin, Kristoffer S.;Lobato, Debra J.;LeLeiko, Neal S.
目的：有喂养问题的儿童通常有多种同时发生的医疗和发育状况；然而，尚不清楚是否存在合并症模式以及它们是否与重要的喂养相关健康结果相关。本研究的主要目的是检查（1）医疗和发育合并症的数量与重要的喂养相关健康结果之间的关系； (2) 各种合并症如何相互作用并形成经验得出的模式； (3) 经验得出的合并症模式如何与体重状况、营养多样性以及儿童和父母进餐行为问题相关。方法：回顾了在喂养障碍门诊就诊的 286 名儿童（平均年龄 = 35.56 个月）的医疗记录。使用标准化措施评估儿童体重状况、营养多样性以及儿童和家长进餐行为问题。一生中发生的医疗和发育状况均得到可靠编码。通过潜在类别分析生成经验派生的合并症模式。结果：潜在类别分析产生了 3 种共病模式：“行为”（58% 的病例）、“发育迟缓”（37%）和“自闭症谱系障碍”（ASD，5%）。研究发现，与行为和发育迟缓组相比，自闭症谱系障碍组的营养种类较少。在理想体重百分比或儿童或家长进餐行为问题的严重程度方面，各组之间没有发现差异。结论：有喂养问题的儿童的多种并发病症根据经验被减少为 3 种合并症模式。合并症模式很大程度上与体重状况和儿童或父母进餐行为问题无关。这表明医疗和发育状况会导致儿童出现喂养问题的一般风险，而不是特定风险。
Objective: Children with feeding problems often have multiple co-occurring medical and developmental conditions; however, it is unknown whether patterns of comorbidity exist and whether they relate to important feeding-related health outcomes. The main objective of this study was to examine (1) the relationship between the number of medical and developmental comorbidities and important feeding-related health outcomes; (2) how various comorbidities interact and form empirically derived patterns; and (3) how empirically derived patterns of comorbidity relate to weight status, nutritional variety, and child and parent mealtime behavior problems. Methods: The medical records of 286 children (mean age = 35.56 months) seen at an outpatient feeding disorders clinic were reviewed. Child weight status, nutritional variety, and child and parent mealtime behavior problems were assessed using standardized measures. The lifetime occurrence of medical and developmental conditions was reliably coded. Empirically derived patterns of comorbidity were generated via latent class analyses. Results: Latent class analyses generated 3 comorbidity patterns: "Behavioral" (58% of cases), "Developmentally Delayed" (37%), and "Autism Spectrum Disorder" (ASD, 5%). The Autism Spectrum Disorder group was found to have less nutritional variety compared to the Behavioral and Developmentally Delayed groups. No differences were found between groups in terms of percent ideal body weight, or severity of child or parent mealtime behavior problems. Conclusion: Multiple co-occurring conditions of children with feeding problems were empirically reduced to 3 patterns of comorbidities. Comorbidity patterns were largely unrelated to weight status and child or parent mealtime behavior problems. This suggests that medical and developmental conditions confer general, rather than specific, risk for feeding problems in children.