Neurobehaviour between birth and 40 weeks' gestation in infants born <30 weeks' gestation and parental psychological wellbeing: predictors of brain development and child outcomes.

Neurobehaviour between birth and 40 weeks' gestation in infants born <30 weeks' gestation and parental psychological wellbeing: predictors of brain development and child outcomes.
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DOI:
10.1186/1471-2431-14-111
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发表时间:
2014-04-24
期刊:
影响因子:
2.4
通讯作者:
Anderson PJ
Anderson PJ
中科院分区:
医学3区
文献类型:
--
作者:
Spittle AJ;Thompson DK;Brown NC;Treyvaud K;Cheong JL;Lee KJ;Pace CC;Olsen J;Allinson LG;Morgan AT;Seal M;Eeles A;Judd F;Doyle LW;Anderson PJ

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与足月出生的同龄人相比,小于30周出生的婴儿患长期神经发育问题的风险增加。据报道,在相当足月年龄的极早产儿中,神经行为检查对随后的损害具有预测价值。然而,对于早产儿在足月前的早期神经行为发育,以及它与围产期因素、大脑结构和后期发育结果的关系,人们知之甚少。此外,母亲的心理健康与儿童的发展有关。鉴于早产儿父母报告的心理困扰率很高,我们必须了解早产后最初几周和几个月的母亲和父亲的健康状况,以及这如何影响亲子关系和儿童的结果。因此,本研究旨在研究1)早期神经行为和2)父母心理健康与早产儿与足月出生婴儿的发育结局之间的关系。这项前瞻性队列研究将描述150名出生时胎龄<30周的婴儿从出生到足月等效年龄的神经行为,并探讨早期神经行为缺陷与磁共振成像确定的脑生长或损伤、围产期因素、父母心理健康以及使用标准化评估工具在足月、1岁和2岁校正年龄测量的后期发育结局的关系。还将招募150名健康足月新生儿作为对照组,以比较结果。为了研究父母心理健康对发育结果的影响,早产儿和足月儿的父母将从孩子出生的第一周到孩子的第二个生日定期完成与焦虑,抑郁和创伤后应激症状相关的标准化问卷。父母与子女的关系将在一岁和两岁的校正年龄进行评估。详细描述极早产后婴儿神经行为和父母心理困扰的轨迹不仅对于识别风险最大的婴儿,进一步了解父母的经历并突出婴儿和/或父母干预的潜在时间非常重要,而且还可以深入了解这对亲子互动和儿童发育的影响。
Infants born <30 weeks’ gestation are at increased risk of long term neurodevelopmental problems compared with term born peers. The predictive value of neurobehavioural examinations at term equivalent age in very preterm infants has been reported for subsequent impairment. Yet there is little knowledge surrounding earlier neurobehavioural development in preterm infants prior to term equivalent age, and how it relates to perinatal factors, cerebral structure, and later developmental outcomes. In addition, maternal psychological wellbeing has been associated with child development. Given the high rate of psychological distress reported by parents of preterm children, it is vital we understand maternal and paternal wellbeing in the early weeks and months after preterm birth and how this influences the parent–child relationship and children’s outcomes. Therefore this study aims to examine how 1) early neurobehaviour and 2) parental mental health relate to developmental outcomes for infants born preterm compared with infants born at term. This prospective cohort study will describe the neurobehaviour of 150 infants born at <30 weeks’ gestational age from birth to term equivalent age, and explore how early neurobehavioural deficits relate to brain growth or injury determined by magnetic resonance imaging, perinatal factors, parental mental health and later developmental outcomes measured using standardised assessment tools at term, one and two years’ corrected age. A control group of 150 healthy term-born infants will also be recruited for comparison of outcomes. To examine the effects of parental mental health on developmental outcomes, both parents of preterm and term-born infants will complete standardised questionnaires related to symptoms of anxiety, depression and post-traumatic stress at regular intervals from the first week of their child’s birth until their child’s second birthday. The parent–child relationship will be assessed at one and two years’ corrected age. Detailing the trajectory of infant neurobehaviour and parental psychological distress following very preterm birth is important not only to identify infants most at risk, further understand the parental experience and highlight potential times for intervention for the infant and/or parent, but also to gain insight into the effect this has on parent–child interaction and child development.
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