在英国，每7个新生儿中就有1个生后被送往新生儿病房入住，包括新生儿重症监护病房和特殊护理婴儿病房。近年来，越来越多被认为有潜在风险的足月儿和正常体重儿也被送入新生儿病房进行观察和治疗，导致新生儿住院率上升。尽管新生儿病房提供了必要的医疗护理，但关于这些儿童在成长过程中的心理健康状况的研究相对较少，且既往研究主要集中在早产儿和低体重儿上，缺乏代表性。

为了更好地理解新生儿期住院与儿童和青少年时期情感和行为困难之间的关联，Nandakumar等[1]基于全国代表性样本（英国千禧一代队列研究，Millennium Cohort Study, MCS）数据，跟踪21世纪初出生的儿童的生活轨迹，以期为改善新生儿病房环境和提供早期干预提供科学依据。

该研究为基于人群的纵向队列研究。纳入MCS中有暴露因素、结局及混杂因素数据的儿童。暴露因素为新生儿期住院情况，通过询问父母“婴儿生后是否被送入特殊护理病房、新生儿病房或重症监护病房”而确定（数据收集于婴儿9月龄时）。主要结局指标为使用“优势与困难问卷（strengths and difficulties questionnaire，SDQ）”评估儿童3岁、5岁、7岁、11岁、14岁及17岁时的情绪和行为问题。通过多层模型结合生长曲线分析新生儿期住院与3-17岁期间情绪及行为问题轨迹的关联，并校正广义混杂因素。

分析样本包含14 013例参与者（48.9%为女性，13.7%为少数族裔）。平均胎龄275.81天（SD=13.80），平均出生体重3.36公斤（SD=0.58）。1 273例（9.1%）参与者曾有新生儿期住院史。完全校正后的模型显示，新生儿期住院与儿童期情绪困难（MD=0.13，95%CI：0.045~0.22，P=0.003）及同伴问题（MD=0.11，95%CI：0.026~0.19，P=0.010）增加相关。未发现新生儿期住院与品行问题（MD=0.013，95%CI：-0.062~0.088，P=0.732）或多动症状（MD=0.042，95% 95%CI：-0.070~0.15，P=0.452）存在关联。

作者认为，生后入住新生儿病房的儿童在成长过程中更易出现情绪困难和同伴问题。这些差异从幼年持续至青春期，提示需优化新生儿病房环境（如减少噪音、促进亲子接触、加强心理健康支持），并对入住新生儿病房的儿童及早实施干预。

原文摘要：

Neonatal unit admission and offspring mental health trajectories across childhood and adolescence: a nationally representative UK cohort study

Objective: To investigate the associations between neonatal unit admission (NNU) and subsequent emotional and behavioural difficulties during childhood and adolescence.

Design: Longitudinal general population cohort study.

Setting: The Millennium Cohort Study: nationally representative UK-based cohort.

Participants: All children with exposure, outcome and confounding data.

Exposure: NNU admission was identified at 9 months by asking parents whether their baby was 'taken to special care or neonatal or intensive care unit after birth'.

Main outcome measures: Emotional and behavioural problems were assessed using the Strengths and Difficulties Questionnaire when children were 3, 5, 7, 11, 14 and 17 years. We explored the association between NNU admission and trajectories of emotional and behavioural problems using multilevel models with growth curves for outcome data between 3-17 years and adjusted for a broad range of confounders.

Results: 14 013 participants (48.9% female, 13.7% ethnic minority) were included in the analytical sample. In the sample, mean gestational age was 275.81 (SD): 13.80) days, and mean birth weight was 3.36 kg (SD=0.58). 1273 (9.1%) participants had an NNU admission. The latter was associated with increased emotional difficulties (mean difference (MD) 0.13, 95% CI 0.045 to 0.22, p=0.003) and peer problems (MD 0.11, 95% CI 0.026 to 0.19, p=0.010) during childhood in fully adjusted models. There was no evidence that NNU admission was associated with conduct problems (MD 0.013, 95% CI -0.062 to 0.088, p=0.732) or hyperactivity symptoms (MD 0.042, 95% CI -0.070 to 0.15, p=0.452).

Conclusions: Children admitted to NNUs at birth are more likely to experience emotional difficulties and peer problems during childhood. These differences are apparent from early childhood continuing into adolescence and strengthen the case for a calm NNU environment with parental visits and mental health support, and early interventions for children admitted to NNUs.

参考文献：略