上海市静安区12月龄婴儿丹佛发育筛查及其智能发育相关因素分析

Survey on infants aged 12 months in Shanghai Jing'an District by Denver Development Screening Test and analysis of their intellectual development relevant risk factors

目的·了解社区儿童早期发育情况并探究影响婴幼儿发育的危险因素。方法·采用整群抽样的方法,对上海市静安区常住12月龄儿童行丹佛发育量表筛查。运用Logistic回归分析探究儿童智能发育影响因素。结果·该调查共收集样本4 102例,抽检异常率为1.0%,可疑异常率为4.3%。Logistic回归分析结果显示低出生体质量(OR=6.24,95%CI 1.69~22.98,P=0.006)、头围偏小(OR=5.22,95%CI 1.20~22.84,P=0.031)、母亲高龄(OR=3.61,95%CI 1.32~9.84,P=0.012)、存在脑损伤史(OR=3.96,95%CI1.55~10.10,P=0.003)是筛查出现异常结果的危险因素。Spearman秩相关分析显示,母乳喂养时长(0~12月)与筛查可疑异常结果呈负相关(ρ=-0.031,P=0.046)。结论·应重视婴儿早期发育筛查和干预,特别是针对母亲为高龄产妇、非正常出生体质量、头围偏小及存在产前或新生儿期高危因素的儿童。母乳喂养有助于降低发育不良结果的检出率。

Objective·To investigate the developmental state of infants in early childhood and identify risk factors for their early development in community. Methods ： Cluster sampling was conducted to collect data of infants aged 12 months by Denver Developmental Screening Test （DDST） in Shanghai Jing＇an District. Logistic analysis was employed to detect factors influencing the intellectual development of infants. Results. A total of 4 102 infants were enrolled in the survey. The prevalence for abnormal screening result was 1.0%, while 4.3% for suspicious abnormal result. Logistic analysis revealed that low birth weight （OR=6.24, 95% C1 1.69-22.98, P=0.006）, low head circumference （OR=5.22, 95% C1 1.20-22.84,p=-0.031）, mothers older than 35 years in pregnancy （OR=3.61, 95%CI 1.32-9.84, p=0.012） or history of brain impairment （0R=3,96, 95% C1 1.55-10,10, P=-0.003） were the risk factors for abnormal screening result. Spearman rank correlation analysis showed a significant negative relationship between breastfeeding duration and suspicious abnormal screening result （p=-0.031, P=0.046）. Conclusion： It is essential to draw attention to early developmental screening and interference, especially to infants with mothers older than 35 years in pregnancy, low birth weight, low head circumference or high-risk infants. Breastfeeding is helpful for decreasing detection rate of abnormal result.