ABSTRACT

Diagnosis and treatment of congenital heart disease (CHD) can present challenges to the developing parent-child relationship due to periods of infant hospitalization and intensive medical care, parent-infant separations, child neurodevelopmental delay and feeding problems, and significant parent and child distress and trauma. Yet, the ways in which CHD may affect the parent-child relationship are not well-understood. We systematically reviewed the evidence on parental bonding, parent-child interaction, and child attachment following CHD diagnosis, according to a pre-registered protocol (CRD42019135687). Six electronic databases were searched for English-language studies comparing a cardiac sample (i.e., expectant parents or parents and their child aged 0–5 years with CHD) with a healthy comparison group on relational outcomes. Of 22 unique studies, most used parent-report measures (73%) and yielded mixed results for parental bonding and parent-child interaction quality. Observational results also varied, although most studies (4 of 6) found difficulties in parent-child interaction on one or more affective or behavioural domains (e.g., lower maternal sensitivity, lower infant responsiveness). Research on parental-fetal bonding, father-child relationships, and child attachment behaviour was lacking. Stronger evidence is needed to determine the nature, prevalence, and predictors of relational disruptions following CHD diagnosis, and to inform targeted screening, prevention, and early intervention programs for at-risk dyads.

摘要

由于婴儿住院和重症监护、亲子分离、儿童神经发育迟缓和喂养问题，以及严重的父母和孩子的痛苦和创伤。然而，冠心病可能影响亲子关系的方式尚不清楚。我们根据预先注册的协议 (CRD42019135687) 系统地审查了冠心病诊断后父母关系、亲子互动和儿童依恋的证据。在六个电子数据库中搜索了比较心脏样本（即，准父母或父母及其 0-5 岁患有 CHD 的孩子）与健康对照组的关系结果的英语研究。在 22 项独特的研究中，大多数使用父母报告的措施（73%），并在父母关系和亲子互动质量方面产生了不同的结果。观察结果也各不相同，尽管大多数研究（6 项中的 4 项）发现亲子互动在一个或多个情感或行为领域存在困难（例如，母亲敏感性较低，婴儿反应性较低）。缺乏对亲子关系、父子关系和儿童依恋行为的研究。需要更有力的证据来确定冠心病诊断后关系中断的性质、患病率和预测因素，并为有针对性的筛查、预防和早期干预计划提供信息。尽管大多数研究（6 项中的 4 项）发现亲子互动在一个或多个情感或行为领域存在困难（例如，母亲敏感性较低，婴儿反应性较低）。缺乏对亲子关系、父子关系和儿童依恋行为的研究。需要更有力的证据来确定冠心病诊断后关系中断的性质、患病率和预测因素，并为有针对性的筛查、预防和早期干预计划提供信息。尽管大多数研究（6 项中的 4 项）发现亲子互动在一个或多个情感或行为领域存在困难（例如，母亲敏感性较低，婴儿反应性较低）。缺乏对亲子关系、父子关系和儿童依恋行为的研究。需要更有力的证据来确定冠心病诊断后关系中断的性质、患病率和预测因素，并为有针对性的筛查、预防和早期干预计划提供信息。