不同分娩方式对学龄期儿童智能及智力结构的影响

Effect of Different Delivery on Intelligence and Intellectual Structure in School Children

目的探讨不同分娩方式对学龄期儿童智能及智力结构的影响。方法 2007年12月-2009年2月以健康体检为主诉就诊的学龄期(6～12岁)儿童306例为研究对象,采用韦氏儿童智力量表(C-WISC)对306例研究对象进行智力测试,排除IQ<85者,并排除有影响智力的其他因素的儿童。由儿童家长填写一般情况调查表,根据母亲孕产期情况分为3组,其中自然分娩组104例,社会因素剖宫产组101例,医学指征剖宫产组101例,3组儿童年龄、性别、出生体质量、父母生育年龄、文化程度、职业、家庭类型、收入、主要带养人等分布均无显著差异,采用单因素方差分析和SNK检验。结果 3组儿童总智商、言语智商、操作智商中除数字广度、记忆/不分心因子智商外其他智力结构和因子智商中各项,均无统计学差异,各组间两两比较差异亦无统计学意义(Pa>0.05)。3组儿童数字广度、记忆/不分心因子智商比较差异有统计学意义(P<0.01,0.05);自然分娩组数字广度优于医学指征剖宫产组和社会因素剖宫产组(Pa<0.05),记忆/不分心因子智商自然分娩组优于医学指征剖宫产组(P<0.05)。结论剖宫产无论有无医学指征对学龄期儿童总智商均无影响,但剖宫产手术本身可能损伤儿童的智力结构,医学指征则加重了这种损伤。

Objective To investigate the effect of different delivery on the intelligence and intellectual structure of school children.Methods Three hundred and six school children aged 6-12 years to request health examination from Dec.2007 to Feb.2009 were selected.The children whose intelligence quotient（IQ） were lower 85 and had other factors which could impact on children′s intelligence were predu-ded.Parents were asked to complete the general information questionnaire.The intelligence of 306 school children were tested by means of the Chinese Revised Wechsler Intelligence Scales for Children（C-WISC）,104 cases were naturally delivered,101 cases were delivered by elective cesarean section,and 101 cases were delivered by cesarean section with medical indication.The differences of age,sex,birth weight,reproductive age,culture level,occupation of their father and mather,homestyle,income,the major person who take care of child were not statistically significant between 3 groups.Variance analysis and SNK test were used to analyze the scores between 3 groups.Results The full intelligence quotient（FIQ）,verbal IQ（VIQ）,performances IQ（PIQ） and the rest of intelligence structure except Digit Span and remember and concentrate factor scores were not statistically significant in 3 groups or between any 2 groups（Pa0.05）.But Digit Span of intelligence structure and remember and concentrate factor scores were significantly different among 3 groups（P0.01,0.05）,naturally delivered group scored highest,while cesarean delivery with medical indication group scored lowest（Pa0.05）.Memory and care factor scores of naturally delivered children scored significantly higher than cesarean delivery with medical indication group（P0.05）.Conclusions The different way of childbirth has no effect on children′s FIQ,including elective and risk-factors cesarean section.But elective cesarean section probably has potential impair on intelligence structure,and risk-factors that caused to cesarean section probably has impair it severity more.