重庆市31902名婴幼儿头围发育情况及头围过小的影响因素分析

Analysis of microcephaly and related factors among 31 902 infants of Chongqing, China

目的：研究重庆市婴幼儿头围发育状况，分析头围过小的影响因素。方法以2010年1月1日至2014年11月1日期间在重庆某医院儿童保健科进行头围检查的31902名（男童17511名，女童14391名）7~24月龄婴幼儿为研究对象，资料包括婴儿性别、年龄、头围、出生情况、母亲妊娠史、喂养方式、父母文化程度等信息；采用独立样本t检验比较男女童头围差异，采用多因素非条件logistic回归模型分析影响婴幼儿头围过小的相关因素。结果7~8、9~10、11~12、13~18、19~24月龄男童头围分别为（44.3±1.3）、（45.2±1.4）、（46.1±1.5）、（46.8±1.4）和（47.8±1.4）cm，女童头围分别为（43.1±1.3）、（44.1±1.3）、（44.8±1.4）、（45.7±1.4）和（46.7±1.3）cm，男童头围均大于女童，差异有统计学意义（t值分别为32.09、27.73、32.21、41.66、32.03，P值均〈0.001）。31902名婴幼儿中头围过小检出率为3.2%（1025名）；多因素logistic回归分析结果显示，出生体重、胎次与婴幼儿头围过小相关，OR（95%CI）值分别为0.15（0.13~0.18）、1.31（1.11~1.54）；相对于郊区居住、足月产、顺产、母乳喂养婴幼儿，市区居住、过期产、剖宫产、人工喂养和混合喂养婴幼儿头围过小的风险较低，OR（95%CI）值分别为0.60（0.52~0.68）、0.55（0.44~0.70）、0.76（0.67~0.87）、0.46（0.32~0.67）、0.51（0.34~0.75）。结论重庆市婴幼儿头围发育总体水平良好，婴幼儿头围过小与家庭环境因素、出生情况及喂养模式密切相关。

Objective To analyze the status of head circumference development and related factors of microcephaly among infants in Chongqing, China. Methods We included infants aged 7-24 months who had received child health care services at a Chongqing hospital from 1 February 2010 to 1 November 2014. We collected data of sex, age, head circumference, childbirth conditions, mother＇s pregnancy history, infant feeding patterns, and parents＇ educational level. Ultimately, 31 902 infants （17 511 males and 14 391 females） were analyzed. The t-test was used to compare head circumference by sex, and logistic regression models used to analyze the related factors of microcephaly. Odds ratios （OR） and 95%confidence intervals （CI） were calculated. Results Among the different age groups （7-8, 9-10, 11-12, 13-18, and 19-24 months）, head circumferences for males were （44.3±1.3）, （45.2±1.4）, （46.1±1.5）, （46.8±1.4）, and （47.8±1.4） cm, respectively;for females, head circumferences were （43.1±1.3）, （44.1±1.3）, （44.8±1.4）, （45.7±1.4）, and （46.7±1.3）cm, respectively. Head circumference for males were all greater than those for girls （t-values were 32.09, 27.73, 32.21, 41.66, and 32.03, respectively; P〈0.001）. The rate of microcephaly was 3.2%（1 025/31 902） among infants. Birth weights and fetal times were related to microcephaly in infants, with OR （95%CI） values 0.15（0.13-0.18） and 1.31（1.11-1.54）, respectively. Factors including urban location, delayed birth, cesarean section, formula feeding, and mixed feeding patterns might reduce the risks of microcephaly compared with suburban location, term birth, eutocia, and breastfeeding; OR （95% CI） values were 0.60 （0.52-0.68）, 0.55 （0.44-0.70）, 0.76 （0.67-0.87）, 0.46 （0.32-0.67）, and 0.51 （0.34-0.75）, respectively.＆amp;nbsp;Conclusion Head circumference development among infants in Chongqing was satisfactory. Family environmental factors, birth conditions, and feeding patterns were found to be important factors related to microcephaly.