Abstract

Objective

Children with hypoxic-ischemic encephalopathy (HIE) are at high risk of neurodevelopmental delay despite the widespread adoption of therapeutic hypothermia. Thus, consideration of both biological and psychosocial factors is warranted to better predict outcomes. We examined the associations between various child neurodevelopmental outcomes and potentially influential factors such as brain imaging, parent mental health, previous intervention, and social risk. Qualitative themes in the parent experience were also identified from free-text questionnaire responses. Methods: Parents of 54 children with HIE (ages 6 months–6.5 years) completed questionnaires capturing sociodemographic factors, qualitative perceptions of clinical outcome, parent mental health, and ratings of child adaptive and psychosocial functioning. Neurodevelopmental assessment scores at 18 and 36 months were extracted retrospectively from the medical chart for a subset of children. Results: Linear regression analyses showed significant associations between poorer parent mental health and child psychosocial and language outcomes. In multivariable analyses, social risk served as a significant predictor of 18 and 36 month cognitive and language functioning. Qualitative analyses of parents’ written reflections revealed themes of hopefulness and ongoing concern. Conclusion: In children with HIE, social context and parent mental health are strong contributing factors in the pathway of neurodevelopmental outcomes.

中文翻译：

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对缺氧缺血性脑病儿童神经发育结果的生物心理社会理解：一项混合方法研究

摘要

客观的

尽管治疗性低温疗法被广泛采用，但患有缺氧缺血性脑病 (HIE) 的儿童仍处于神经发育延迟的高风险中。因此，有必要同时考虑生物学和社会心理因素以更好地预测结果。我们检查了各种儿童神经发育结果与潜在影响因素（如大脑成像、父母心理健康、先前干预和社会风险）之间的关联。家长体验中的定性主题也从自由文本问卷答复中确定。方法：54 名 HIE 儿童（6 个月至 6.5 岁）的父母完成了调查问卷，这些问卷包括社会人口学因素、临床结果的定性看法、父母的心理健康以及儿童适应性和社会心理功能的评级。从一部分儿童的病历中回顾性提取 18 个月和 36 个月时的神经发育评估分数。结果：线性回归分析显示较差的父母心理健康与儿童心理社会和语言结果之间存在显着关联。在多变量分析中，社会风险是 18 和 36 个月认知和语言功能的重要预测因子。对父母书面反思的定性分析揭示了充满希望和持续关注的主题。结论： 在患有 HIE 的儿童中，社会环境和父母的心理健康是神经发育结果途径中的重要促成因素。