脐血嗜酸性粒细胞阳离子蛋白与早期婴儿特应性皮炎相关性的前瞻性研究

目的探讨脐血嗜酸性粒细胞阳离子蛋白(ECP)、脐血特异性IgE(sIgE)与父母特应质、婴儿特应性皮炎和食物皮肤点刺试验阳性率之间的相关性,为婴儿早期过敏性疾病的发生风险提供前瞻性检测指标。方法选择2009年6月至2010年3月期间分娩的健康新生儿及其母亲,调查父母特应质情况。收集并检测脐血中ECP、鸡蛋和牛奶sIgE的含量。随访婴儿,记录出生后6周、3个月、6个月时的特应性皮炎发生情况,并在婴儿出生后3、6个月时实施食物皮肤点刺试验。结果调查并随访146例婴儿及其母亲。父母为特应质与非特应质的婴儿比较,其脐血ECP含量差异无统计学意义(P>0.05)。新生儿脐血中鸡蛋、牛奶sIgE均为阴性。按脐血中ECP含量是否>10μg/L将婴儿分为2组,婴儿出生后6周、3个月、6个月时,特应性皮炎发病率在ECP增高婴儿中均高于正常者(P<0.01)。脐血ECP含量与婴儿3、6个月时的食物皮肤点刺试验阳性率无相关性(P>0.05)。结论父母特应质对脐血ECP水平无影响。新生儿脐血中鸡蛋、牛奶sIgE均为阴性,故孕末期回避饮食依据不足。脐血ECP增高与婴儿早期特应性皮炎发生有显著相关性,而脐血ECP含量与婴儿3、6个月时的...     

石景山区婴儿辅食添加情况及影响因素调查

目的寻找婴儿辅食添加中存在的问题,调查其影响因素。方法在固定的保健门诊日由儿保医师对保健体检的婴儿母亲或喂养人进行问卷调查。并对调查结果进行分析。结果1.辅食早加率(<4个月)23.9%,辅食早加行为与不同喂奶方式比较差异有显著意义(P<0.05)。2.本地区辅食开始添加的时间74%选择4～6个月;开始添加的品种较为适宜(蛋黄或米粉);但肉豆类适时(6～8个月)添加率不足30%,未添加率达30%左右,且应用频数低,与成人1周膳食频度比较有显著性差异。3.母亲在喂养中起着重要作用,但未注意到行为习惯的培养,尚缺乏喂养知识。结论婴儿辅食喂养中存在着一些问题,需要改善。关键是要对起重要作用的母亲进行教育。     

婴儿辅食添加情况调查分析

目的了解婴儿辅食添加情况。方法采取整群随机抽样的方法，以问卷形式现场调查800例0—12个月婴幼儿父母进行婴儿辅食添加相关因素情况。结果4～6个月婴儿粮谷、蛋类、鱼、肉类、豆制品、蔬菜、水果的添加率分别为82．25％、84．50％、25．50％、0、52．25％、24．50％、51％，婴儿辅食添加的好坏直接与喂养知识的强化培训密切相关，而与家庭经济收入的高低不一定相关。结论加强健康教育把育儿知识交给家长，才能促进儿童的体格发育。     

0～4个月婴儿早期教育效果的研究

目的：探讨0－4个月婴儿早期教育的效果。方法：儿科医师向实验组家长讲明0－3岁教育大纲及意义，指导家长对其婴儿进行早期教育，婴儿4个月时由儿科医师对婴儿做智能测查，并分析实验组与常规育儿组婴儿智力发育指数（MDI）及心理运动发育指数（PDI）的差异。结果：实验组MDI及PDI明显高于常规育儿组，两组最大的差异在于动手能力的不同，结论：婴儿早期教育的效果是显著的。     

新生儿及新生儿疾病

990012婴儿脑室的测量/张伟利…//中华儿科杂志一1998,36(1)一34一36 采用颅脑超声测量255例正常婴儿脑室。结果:男女婴儿脑室大小无显著差异,分娩方式对脑室大小无明显影响。3个月和6个月婴儿的头围、大脑半球宽度及脑室测定值均分别大于新生儿和3个月婴儿。12个月婴儿的头围和大脑半球宽度均显著大于6个月婴儿,但脑室测定值与6个月婴儿相比,无显著差异。表4参8(姜红) 990013母血和新生儿脐血长链多不饱和脂肪酸水平及其临床意义/张瑛…//中华儿童保健杂志一1998,6(1)一15一16 了解母亲长链多不饱和脂肪酸对胎儿的影响。用毛细管气相色谱法…     

重视儿科营养学基础数据积累

本期刊登了重庆医科大学附属儿童医院“4～12个月中国婴儿能量摄入研究”的临床观察报告。试图回答婴儿能量摄入与中国婴儿6个月之后生长曲线之间的关系,并尝试用膳食调查的方法回答这一阶段与能量摄入相关的重要因素;是儿科医生应用营养学方法研究并解答临床实际问题的尝试,对指导较大婴儿喂养等临床问题有实际的意义,也提示出一些问题值得我们思考。     

喂养方式与婴儿生长发育速度关系的研究

目的 探讨不同喂养方式对婴儿生长发育速度的影响。方法 分析3种喂养方式婴儿不同年龄阶段生长发育速度情况。结果 在3种喂养方式中，母乳喂养组婴儿体重和身长增长速率最快，其次是混合喂养组。经方差分析母乳喂养组与其他2种喂养方式婴儿体重和身长增长速率差异具有显著性。人工喂养组婴儿头围增长速率最快，其次为混合喂养组，经方差分析人工喂养组与其他2种喂养方式婴儿头围增长速率差异具有显著性。纯母乳喂养的0—3个月婴儿身高增量大；纯母乳喂养、接受喂养宣教、新生儿期患病少、母亲孕期食欲好，0～3个月婴儿体重增量大；纯母乳喂养、母亲文化程度高、接受喂养宣教、新生儿期患病少，0～3个月婴儿头围增量大。结论 4个月以内婴儿纯母乳喂养可大大促进婴儿的生长发育。     

上海社区婴儿腹泻发生情况及相关因素分析

目的 探讨上海社区婴儿腹泻的发生情况以及影响腹泻的相关因素。方法 收集2011年7月至2012年 4月于上海闵行区12个社区首次参加体检的婴儿6661例, 采用多中心、 前瞻性研究的方法, 通过为期1年的随访调查, 统计12月内婴儿的腹泻情况及出生史、 喂养史、 家庭情况和营养状况等。结果 6661例婴儿中男性3523例, 女性3138例。0～3月龄腹泻发生率为1.3%, 4～6月龄为3.0%, 7～9月龄为3.9%,10～12月龄为4.4%。12月龄内人均腹泻次数为0.13次。家庭收入、喂养方式、抚养方式、母亲文化程度及户籍等是婴儿腹泻的影响因素。结论 上海婴儿腹泻发生率较过去有所下降。影响婴儿腹泻的主要因素为家庭收入、喂养方式、抚养方式、母亲文化程度及户籍等。     

6~12月龄婴儿缺铁性贫血的危险因素分析及对神经心理发育的影响

目的 探讨6~12月龄婴儿中、重度缺铁性贫血(IDA)的危险因素,并初步了解IDA对婴儿神经运动发育的影响及其气质特点。方法 326例6~12月龄IDA患儿为研究对象,按贫血程度分为轻度(176例)、中度(111例)、重度(39例)组 ,采用多因素logistic回归分析对中、重度IDA的危险因素进行调查。另选取同期年龄、性别等背景相匹配的346例非IDA儿童作为对照组。IDA和对照组两组均使用儿童Gesell婴幼儿发育量表、气质量表进行智能发育及气质的评估。结果 单因素分析显示,性别、出生体重、胎龄、多胎、母亲孕期贫血、母亲缺乏IDA相关知识与贫血程度有关(P< 0.05)。以轻度IDA组为对照,多因素logistic回归分析显示,多胎、早产、低出生体重(< 2 500 g)、母亲孕期贫血、母乳喂养、母亲缺乏IDA相关知识是重度贫血的危险因素(OR> 1,P< 0.05);早产,母乳喂养、混合喂养是中度贫血的危险因素(OR> 1,P< 0.05)。IDA组Gesell总发育商、大运动、适应行为、精细动作得分较对照组低(P< 0.05)。IDA组难养型及中间偏难养型气质的比例较高(P< 0.05)。IDA组活动水平、节律性、适应性、坚持性维度得分较对照组高(P< 0.05)。结论 早产、多胎、低出生体重、喂养方式、母亲孕期贫血及母亲缺乏IDA相关知识与6~12月龄婴儿IDA贫血程度相关。IDA患儿神经运动发育落后,消极气质类型居多,需加强对患儿心理行为问题的重视,指导家长选择恰当的喂养及教育方式。     

婴儿牛奶蛋白过敏的危险因素：多中心调查分析

目的 通过多中心临床研究了解婴儿牛奶蛋白过敏（CMPA）发生的危险因素。方法 以2016年6月至2017年5月于深圳市6家医院儿科门诊就诊的1 829例1~12月龄婴儿为调查对象，通过问卷调查，筛选CMPA可疑病例，然后进行食物回避激发试验以确诊CMPA。采用多因素logistic回归分析调查婴儿CMPA发生的危险因素。结果 1 829例患儿中，82例确诊为CMPA（4.48%）。多因素logistic回归分析显示，母亲食物过敏（OR=4.91，95% CI：2.24~10.76）、母亲孕期使用抗生素（OR=3.18，95% CI：1.32~7.65）、开始添加辅食月龄小于 < 4个月（OR=3.55，95% CI：1.52~8.27）是CMPA的独立危险因素（P < 0.05），而纯母乳喂养（OR=0.21，95% CI：0.08~0.58）和 > 6个月添加辅食（OR=0.38，95% CI：0.17~0.86）是CMPA的保护因素（P < 0.05）。结论 小于4月龄添加辅食、母亲食物过敏、母孕期使用抗生素是婴儿CMPA发生的危险因素。     

Attachment classifications among 18-month-old children of adolescent mothers.

OBJECTIVES: To determine (1) patterns of secure vs insecure attachment relationships in infants of adolescent and nonadolescent mothers and (2) if these patterns are mediated by parenting characteristics, including depression, self-esteem, parenting stress, child abuse potential, psychological distress, rating of infant temperament, and the caregiving environment. PARTICIPANTS: Fifty-one adolescent mothers and their 18-month-old infants were compared with 76 nonadolescent mothers and their 18-month-old infants. MAIN OUTCOME MEASURES: Infant attachment classifications were assessed via the Ainsworth Strange Situation. Maternal and infant characteristics were obtained through self-report measures. RESULTS: There were no differences in attachment classification between infants of adolescent mothers and nonadolescent mothers. Secure attachment classification was found in 67% of the infants of adolescent mothers and 62% of the infants of nonadolescent mothers. There were significant differences in the self-reported maternal characteristics. Adolescent mothers reported lower self-esteem (P<.05), more parenting stress (P<.05), more child abuse potential (P<.05), and provided a lower quality of home environment (P<.05) than nonadolescent mothers. Adolescent mothers also rated their infants as having a higher activity level (P<.05) than infants born to nonadolescent mothers. In multivariate analysis, none of these variables or social classes were found to affect attachment classification. CONCLUSIONS: Infants of adolescent and nonadolescent mothers show similar patterns of attachment. Adolescent and nonadolescent mothers show substantial differences in parenting characteristics and in how they rate their infants' temperaments. However, these differences do not seem to impair the infant-mother attachment relationship.     

Parenting stress in mothers of very preterm infants — Influence of development,temperament and maternal depression

Objective

To measure levels of parenting stress and postnatal depression in mothers of very preterm infants in comparison with mothers of infants born at term is the objective of this study. The study also aimed to explore factors associated with parenting stress in the mothers of the preterm infants.

Methods

One hundred and five mothers who delivered 124 babies at ≤ 30 weeks gestation were enrolled together with 105 term mothers who delivered 120 babies. At one year of age (corrected for prematurity for the preterm cohort), the mothers completed the Parenting Stress Index Short Form (PSI), the Edinburgh Postnatal Depression Scale (EPDS) and the Short Temperament Scale for Toddlers. The infants had neurodevelopmental assessment. The preterm and term groups were compared.

Results

Questionnaires were completed by 101 of the preterm mothers and 98 of the term mothers. The mean PSI Total Stress score was significantly higher for the preterm mothers (70.28 vs 64.52, p = 0.022), with 19% of the preterm group and 9% of the term group having high scores (p = 0.038).There was no group difference on the EPDS or measures of temperament, with disability being greater in the preterm infants. For the preterm group, maternal depression and infant temperament were independent predictors of Total Stress scores on multivariate analysis.

Conclusions

Parenting stress in mothers of preterm infants at one year of age is significantly greater than that found in mothers of term infants. For preterm mothers, symptoms of depression and infant temperament are independent risk factors for higher levels of parenting stress.     

The effects of maternal social phobia on mother-infant interactions and infant social responsiveness

BACKGROUND: Social phobia aggregates in families. The genetic contribution to intergenerational transmission is modest, and parenting is considered important. Research on the effects of social phobia on parenting has been subject to problems of small sample size, heterogeneity of samples and lack of specificity of observational frameworks. We addressed these problems in the current study. METHODS: We assessed mothers with social phobia (N = 84) and control mothers (N = 89) at 10 weeks in face-to-face interactions with their infants, and during a social challenge, namely, engaging with a stranger. We also assessed mothers with generalised anxiety disorder (GAD) (N = 50). We examined the contribution to infant social responsiveness of early infant characteristics (neonatal irritability), as well as maternal behaviour. RESULTS: Mothers with social phobia were no less sensitive to their infants during face-to-face interactions than control mothers, but when interacting with the stranger they appeared more anxious, engaged less with the stranger themselves, and were less encouraging of the infant's interaction with the stranger; infants of index mothers also showed reduced social responsiveness to the stranger. These differences did not apply to mothers with GAD and their infants. Regression analyses showed that the reduction in social responsiveness in infants of mothers with social phobia was predicted by neonatal irritability and the degree to which the mother encouraged the infant to interact with the stranger. CONCLUSIONS: Mothers with social phobia show specific parenting difficulties, and their infants show early signs of reduced social responsiveness that are related to both individual infant differences and a lack of maternal encouragement to engage in social interactions.     

Mothers of preterm and full-term infants on home apnea monitors

We prospectively studied the stress perception of ten mothers of preterm infants on apnea monitors (birth weight, 1255 +/- 295 g) and ten mothers of term infants on monitors (3156 +/- 700 g) and compared them with 15 mothers of preterm infants (1450 +/- 305 g) and 15 mothers of term infants (3360 +/- 595 g) not on monitors. The Life Experience Survey, a stress assessment questionnaire, and the social support questionnaire of Henderson were administered to the 50 mothers. Stress perception scores were higher for mothers of infants on monitors than for mothers of infants not on monitors. Regression analyses indicated that mothers of infants on monitors experienced less perceived stress when they received greater support. Mothers of infants on monitors who experienced less stress reported greater general life satisfaction and greater satisfaction with parenting.     

Infant, mother, and contextual predictors of mother-very low birth weight infant interaction at 9 months of age

This prospective study examined how characteristics of infants (i.e., birth weight and perinatal illness severity), mothers (i.e., anxiety and level of education), and the social context (i.e., maternal received and perceived helpfulness of support) related to mother-very low birth weight (VLBW) infant interaction in 72 dyads. Infant, mother, and contextual factors were assessed at 3 and 9 months of age, and mothers and infants were observed in teaching interactions at 9 months. Dyads whose interaction was more sensitive and responsive included mothers who were better educated and less anxious at 3 months and reported higher perceived support at 3 months. The findings highlight the importance of maternal education and well-being in the parenting of VLBW infants.     

Direct and mediated effects of nativity and other indicators of acculturation on Hispanic mothers' use of physical aggression

This study used data from 845 foreign-born (n = 328) and native-U.S. born (n = 517) Hispanic mothers who participated in the Fragile Families and Child Wellbeing Study (FFCWS) to examine four indicators of acculturation--nativity, years lived in the United States, religious attendance, and endorsement of traditional gender norms--as predictors of maternal physical aggression directed toward young children. The authors also examined whether psychosocial risk factors associated with child maltreatment and acculturation--maternal alcohol use, depression, parenting stress, and intimate partner aggression and violence--mediate relationships between acculturation and maternal aggression. Foreign-born Hispanic mothers had significantly lower rates of physical aggression than native-born Hispanic mothers. In path modeling results, U.S. nativity, along with maternal alcohol use, parenting stress, and child aggressive behavior, emerged as the strongest risk factors for maternal physical aggression. Among the four acculturation indicators, only foreign birth was directly associated with lower maternal aggression. Study findings suggest immigrant status is a unique protective factor that contributes to lower levels of physical aggression among Hispanic mothers.     

Parental psychological well-being and cognitive development of very low birth weight infants at 2 years

Aim: To assess the associations between cognitive development of very low birth weight (VLBW) infants and measures of parental psychological well‐being. Methods: In this prospective cohort study, 182 VLBW infants born 1/2001–12/2006 at the Turku University Hospital, Finland, were followed up. At 2 years corrected age, cognitive development of the child was assessed using the Mental Development Index of Bayley Scales, and both parents filled in validated questionnaires defining parental psychological well‐being (Beck Depression Inventory, Parenting Stress Index and Sense of Coherence Scale). Results: The cognitive delay of the infant was associated with paternal symptoms of depression (p = 0.007) and parenting stress (p = 0.03). Mothers of the infants with cognitive delay reported increased parenting stress related to the difficulty to accept the child (p = 0.001). Weak sense of coherence predicted depressive symptoms in both parents (p < 0.0001). Conclusion: Even if the fathers of VLBW infants experienced depressive symptoms less often than the mothers, the ability of the fathers to cope was significantly associated with the cognitive development of the infant. In addition, the fathers reported more parenting stress if the infant had a cognitive delay. The mothers reported more parenting stress related to accepting the VLBW infant with cognitive delay.     

Parenting the premature infant: balancing vulnerability and quality of life

BACKGROUND: Relationships between child quality of life (QOL), maternal well-being and parenting were explored in a questionnaire study. METHOD: Mothers of 126 full-term (FT) and 91 pre-term (PT) infants during the child's second year of life completed measures of their own and the child's quality of life and behavioural difficulties. We developed a measure of parenting style derived from Regulatory Focus Theory (RFT), to distinguish greater reported use of promotion as opposed to prevention strategies (emphasising gains rather than losses, and encouraging pursuit of goals rather than prevention of harm). RESULTS: The two groups of mothers showed no differences on the parenting measure, but those in the PT compared with the FT group described their infant as having lower QOL and more behavioural and mood problems, and rated their own well-being as less satisfactory. Greater use of promotion was associated with reports of fewer difficulties (better QOL) for the child and better mothers' well-being. Differences in mothers' well-being as a function of group (FT vs. PT) and promotion were strongly mediated by mothers' perceptions of their child's difficulties. At the same time, associations with child difficulties were partly mediated by mothers' well-being, suggesting that maternal distress may have partly contributed to higher perceptions of such difficulties. Among PT infants, the degree of prematurity predicted child difficulties, but was not consistently related to mothers' well-being. DISCUSSION: Mothers of PT infants report more physical health and behavioural difficulties than mothers of FT infants, but specific parenting styles can contribute to child difficulties and QOL in both infants and their mothers. CONCLUSION: We conclude that RFT has potential for understanding the conflicts experienced by parents caring for vulnerable children.