5162例社区12月龄婴儿智力发育筛查及影响因素分析

Risk factors of abnormal mental development in infants: analysis of screening result among 5 162 infants aged 12 months

目的探讨与社区12月龄婴儿智力发育水平有关的影响因素,为早期干预提供理论依据。方法采用整群抽样的方式抽取于2011年1月至2014年12月期间出生、在上海市静安区妇幼保健所和所辖5家街道社区卫生服务中心儿童保健门诊接受过儿童保健检查且检查记录完整的5 162例12月龄婴儿为研究对象。采用上海市DenverⅡ发育筛查量表对所有研究对象进行智力发育筛查,通过单因素和多因素Logistics回归模型分析影响12月龄婴儿智力发育的影响因素。结果本研究的5 162例婴儿发育筛查未通过率(可疑和异常)达3.5%,多因素逐步Logistic回归分析显示:婴儿12月龄时肥胖(OR=1.50,95%CI:1.13~1.85)、超重(OR=1.38,95%CI:1.11~1.90)、消瘦(OR=2.36,95%CI:1.48~3.89);出生早产合并低出生体质量(OR=2.47,95%CI:1.61~3.80)、巨大儿(OR=1.99,95%CI:1.25~3.18)、出生窒息(OR=3.25,95%CI:2.82~5.22)是婴儿智力发育筛查未通过的危险因素。结论社区12月龄婴儿早期智力发育水平主要与婴儿营养状况和出生高危因素有关,应采取针对性的早期干预措施预防婴儿智力发育障碍。

Objective To investigate the risk factors associated with abnormal mental developmental in 12-month infants.Methods Total 5 162 infants born from Jan 2011 to Dec 2014 were selected as study subjects by cluster sampling method from Shanghai Jing’an District Maternal and Child Health Care Center and five affiliated community health service centers.The mental status was screened with Shanghai Denver Ⅱ Developmental Screening Test,and influencing factors of abnormal mental development were analyzed with multivariate regression analysis.Results The detection rate of abnormal ( or suspicious) mental development in 5 162 screened infants was 3.5% .Multivariate logistic regression analysis showed that the infants with obesity at 12 months ( OR= 1.50,95% CI: 1.13-1.85) ,overweight at 12 months ( OR= 1.38,95% CI: 1.11-1.90 ) ,wasting at 12 months ( OR= 2.36,95% CI: 1.48-3.89 ) and preterm birth with low birth weight ( OR= 2.47,95% CI: 1.61-3.80) ,macrosomia( OR= 1.99,95%CI: 1.25-3.18 ) ,birth asphyxia ( OR= 3.25,95% CI: 2.82-5.22 ) were risk factors for abnormal mental development.Conclusion The mental development of 12 months infants is related to nutritional status,high risks at pregnancy and birth.To prevent abnormal mental development,early interventions are necessary.