Infantile colic. Risk factors in pregnancy, maternal reports and outcome at 4 years of age

Sammanfattning: AIM: To study infantile colic in terms of occurrence, risk factors in pregnancy, distress patterns, caregiving practices, and outcome. STUDY DESIGNS: Paper I: Population study, 376 mothers and newborn infants, diaries or telephone interviews. Paper II: 116 colic and 119 control cases, telephone interviews, and diaries. Papers III-IV: Population study, 1099 mother-infant dyads, pregnancy inquiries, and telephone interviews. Paper V: 50 colic and 102 control cases from first study, postal inquiries. RESULTS: · The colic incidence, according to modified Wessel's criteria, was 11.7% in the first and 9.4% in the second study. · Diaries in the second study revealed generally low distress amounts: 1.1 hours/day in the control group, 1.6 hours/day in the non-Wessel colic group and 3.5 hours/day in the Wessel colic group. · In the Wessel colic group distress episodes were frequent and long-lasting and there was a high proportion of colicky crying vs. fussing/normal crying. · The average amounts of added holding and feeding time were, in the control, non-Wessel colic, and Wessel colic groups, 7.1, 7.9, and 9.1 hours/day, and the mean feeding frequencies were 10.0, 10.2, and 10.6 times/day. · Women who had stated in late pregnancy interviews that there is a risk of spoiling an infant with too much physical contact, were more likely to have infants with colic, and their infants were more distressed, even when actually given the same amount of physical contact. · There was a higher risk of colic in infants born to mothers with low instrumental support in pregnancy, and mothers with non-manual occupations. Having an 'active' job situation, i.e. high demands and high decision latitude at work, acted synergistically with a non-manual occupation, yielding even higher odds ratios for colic. · High trait anxiety in early pregnancy was a risk factor for colic, especially if combined with low maternal age. A high educational level reduced the effects of high trait anxiety. · In the 4-year follow-up study, there were no major differences between formerly colicky children and controls. However, in the ex-colicky group there were more negative emotions according to the temperament scale. Implications of the findings, as regards attentions in maternity health care to pregnant women in different risk groups, and on appropriate advice to give to parents in child health care, are discussed, and ideas for future research are outlined.