夜醒与婴幼儿认知发育的相关性研究

The association between night waking and infant cognitive development

目的了解影响婴幼儿夜醒的环境因素，探讨婴幼儿夜醒与认知发育的相关性。方法随机抽取2011年12月-2013年2月义乌市城区和乡镇各1个点作为项目点，共抽取2～30个月婴幼儿116名。以问卷形式对儿童及其家长进行调查，了解儿童出生及家庭社会经济的相关情况；采用简易婴儿睡眠问卷（BISQ）收集儿童夜醒次数及时间等相关睡眠情况；同时采用Bayley婴幼儿发育量表进行婴幼儿认知发育评估。结果调查对象平均年龄为（12．99±8．55）月（2～30个月），男孩占50．86％（59／116）。〈1岁婴儿，偶尔夜醒仅占5．26％，夜醒1次占29．82％，夜醒多次占64．91％；91岁幼儿则分别为32．20％、45．76％和22．03％。〈1岁婴儿和≥1岁幼儿夜醒次数的分布差异有统计学意义（P〈0．01）。〈1岁婴儿平均夜醒时间为（0．49±0.31）h，≥1岁幼儿为（0．31±0.48）h，差异有统计学意义（Z=4．35，P〈0．001）。31岁幼儿随着夜醒次数增加，智力发育指数（MDI）下降，差异有统计学意义（F=3．98，P=0．024）；夜醒时间与MDI呈显著负相关（r=-0．26，P=0．035）。〈1岁婴儿的夜醒次数和夜醒时间与MDI无相关性。多元线性回归分析证实夜醒次数及时间是≥1岁幼）LMDI的独立影响因素。结论对持续夜醒婴幼儿应引起高度关注。

Objective To explore the role of night waking in the cognitive development of infants and young toddlers. Method A total of 116 infants aged 2 to 30 months were randomly selected in Yiwu, Zhejiang from December 2011 to February 2013. Social-demographic factors were investigated through questionnaire; sleep information were collected via the Brief Infant Sleep Questionnaire （BISQ）; Cognitive development was assessed in all infants using Baley development scale. Results The mean age was 12.99 month-old. 50.86% （59/116） were males. Ocassional night waking was reported in 5.26%, one night waking in 29.82%, multiple night waking accounted in 64.91% of children under one year old. Ocassional night waking was reported in 32.20%, one night waking in 45.76%, multiple night waking in 22.03% of children over one year old. The frequency of night waking was significantly different between children under one year old and children over one year old （P〈0.01）. The average duration of waking was 0.49±0.31 h in children under one year old, and 0.31±0.48 h in children older than one year old, and the difference was significantly different （Z=4.35, P〈0.001）. In children over one year old, the more frequent night waking, the lowered MDI scores （F=3.98, P=0.024）. The waking duration was negatively correlated with MDI scores in children over one year old （r=-0.26, P=0.035）. Neither night waking duration nor night waking frequency had significant correlation with MDI scores in children under one year old. Multivariable linear regression confirmed that night waking was an independent influential factor of MDI and PDI scores in children over one year old. Conclusions Persistent night waking should warrant attention.