晋黔贫困地区3岁以下儿童身高/长与神经行为发育关联性研究

Association of child linear growth and neurodevelopment among children under 3 years old in poverty-stricken areas

目的探讨3岁以下儿童身高/长与神经行为发育之间的关系,为后续干预提供建议。方法数据来源于2013年7-9月在山西、贵州六县开展的3岁以下儿童及其看护人的横断面调查,用非参数检验法和线性回归分析探究儿童身高/长与神经行为发育之间的关系。结果调查地区3岁以下儿童身高/长标准化得分(HAZ)为-0.73±1.44,年龄与发育进程问卷(ASQ)Z评分为-0.08(-1.30,0.77)。1~17月龄身高/长正常组儿童的ASQ-Z评分高于生长不足组0.36,高于生长迟缓组0.78,且差异有统计学意义(P<0.05)。在控制儿童性别、月龄、看护人基本情况、家庭经济状况混杂因素后,HAZ每升高1s,ASQ-Z评分增加0.106s。结论调查地区儿童身高/长与神经行为发育存在正相关。生长不足是影响低龄儿童神经行为发育的独立因素。生长监测工作中,要兼顾生长不足和生长迟缓儿童的早期发展指导和促进。

Objective To examine the association of linear growth and neurodevelopment among children under 3 years old in impoverished areas of Guizhou and Shanxi Province,in order to provide suggestions fro further intervention. Methods Data were obtained from the cross-sectional study conducted among children under 3 and their caregivers in six poverty-stricken counties from July to September in 2013.Non-parametric test and general linear regression analysis were performed to investigate the association of child linear growth and early neurodevelopment. Results The height-for-age Z-score(HAZ),the median standardized Age and Stages Questionnaire Z score(ASQ Z-score) using the Chinese national norms for children was-0.73±1.44 and-0.08(-1.30,0.77),respectively.Among children aged 1 to 17 months,the ASQ Z-score for the healthy children group was 0.36 higher than the growth insufficiency group,0.78 higher than the growth retardation group(P<0.05).After controlling for children′s sex,age,caregivers′ age,sex,ethnicity,education,the primary caregivers,family income and household access to internet,the ASQ Z-score increased by 0.106s for every 1s increase in HAZ. Conclusions Child linear growth is positively correlated with early neurodevelopment.Linear growth deficit is an independent risk factor of child neurodevelopment in young children in resource-poor settings of rural China.In the routine growth monitoring and counselling services,the guidance and promotion of early development of children with growth deficits and stunting should be taken into account.