| 洪佳仪,魏倩,井光壮,叶佩琪,石宇阳,史慧静.孕期应激生活事件暴露水平对儿童2~6岁内情绪与行为问题的影响[J].中华流行病学杂志,2024,45(3):401-407 |
| 孕期应激生活事件暴露水平对儿童2~6岁内情绪与行为问题的影响 |
| Effect of prenatal stressful life event exposure on child emotional and behavioral problem at age 2-6 years |
| 收稿日期:2023-08-16 出版日期:2024-03-21 |
| DOI：10.3760/cma.j.cn112338-20230816-00072 |
| 中文关键词: 孕期 应激生活事件 学龄前儿童 情绪与行为问题 队列研究 |
| 英文关键词: Prenatal Stressful life event Preschool child Emotional and behavioral problem Cohort study |
| 基金项目:上海市加强公共卫生体系建设第六轮重点学科建设项目（GWVI-11.1-32）；福建省卫健委科技计划重大科研专项项目（2021ZD01002） |
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| 中文摘要: |
| 目的 研究母亲孕期应激生活事件暴露水平对儿童2~6岁内情绪与行为问题的影响。方法 上海亲子队列于2016-2018年招募待产孕妇建卡并随访，本研究纳入来自队列的2 524对母子，使用量表于孕早、晚期评估母亲应激生活事件暴露水平，儿童2~6岁内评估情绪与行为问题。使用多因素二元logistic回归模型及广义估计方程分析孕期应激生活事件暴露水平对儿童2~6岁内情绪与行为问题发生风险的影响及作用关键期。结果 孕期应激生活事件暴露水平持续较低、仅孕早期较高、仅孕晚期较高、持续较高的母亲分别占61.8%、13.2%、13.2%和11.8%。儿童3~6岁的情绪症状、多动问题、同伴交往及困难总分异常检出率在持续较高组中最高。广义估计方程结果显示，与孕期应激生活事件暴露水平持续较低组相比，仅孕早期较高组的儿童2~6岁内品行问题（aOR=1.41，95%CI：1.07~1.87）异常发生风险显著增加，孕期应激生活事件暴露水平持续较高组的儿童情绪症状（aOR=1.41，95%CI：1.09~1.83）、同伴交往（aOR=1.46，95%CI：1.15~1.86）及困难总分（aOR=1.51，95%CI：1.17~1.93）异常发生风险均显著增加。结论 母亲孕期应激生活事件暴露增加儿童2~6岁内情绪与行为问题异常发生风险，孕早期可能是暴露关键期。 |
| 英文摘要: |
| Objective To investigate the influence of prenatal stressful life event (SLE) exposure on child emotional and behavioral problem at age 2-6 years and identify the most risk exposure period. Methods A total of 2 524 mother-child pairs were selected from Shanghai Maternal-Child Pairs Cohort based on pregnant women form 2016 to 2018 in Shanghai. Prenatal SLE exposure was assessed by Life Events Scale for Pregnant Women Questionnaire during the first and third trimester of pregnancy. Child emotional and behavioral problem was evaluated by Strengths and Difficulties Questionnaire at age 2-6 years. Multivariate binary logistic regression model and generalized estimating equation were conducted to quantify the association between prenatal SLE exposure and child emotional and behavioral problem at age 2-6 years, and identify the pregnancy period with strongest adverse effect. Results The 2 524 mother-child pairs were divided into 4 groups: group with consistent low exposure to SLE (61.8%), group with high exposure to SLE in the first trimester (13.2%), group with high exposure to SLE in the third trimester (13.2%) and group with consistent high exposure to SLE (11.8%). The detection rates of emotional problem, hyperactivity, peer interaction problem and total difficulty score in children aged 3-6 years were highest in the group with consistent high exposure to SLE. Generalized estimating equation analysis showed that after controlling the confounding factors, compared with the consistent low exposure group, the children in the group with high exposure to SLE in the first trimester had significant increased risk for conduct problem at age 2-6 years (aOR=1.41, 95%CI:1.07-1.87). The children in the group with consistent high exposure to SLE were at increased risk for emotional problem, peer interaction problem, and high total difficulty score with the aOR of 1.41 (95%CI: 1.09-1.83), 1.46 (95%CI: 1.15-1.86) and 1.51(95%CI: 1.17-1.93). Conclusion These findings indicated that prenatal exposure to SLE have adverse effect on child emotional and behavioral problem at age 2-6 years, especially the exposure in the first trimester. |
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