3~59月龄儿童社交情绪发育状况及其与早产的关联

Prevalence of suspected developmental delay in social-emotional development and its correlation with preterm birth among children aged 3~59 months

目的了解中国中西部8个县中3~59月龄儿童社交情绪可疑发育迟缓检出率并探讨其与早产的关系。方法采用现况研究和人口容量比例概率抽样法,于2016年10月至2017年1月间调查了新疆、青海、宁夏、江西4省中8个县1927名3~59月龄儿童及其主要看护人,使用由看护人完成的年龄与发育进程问卷:社交-情绪中文版评估儿童社交情绪可疑发育迟缓状况。运用Logistic回归进行多因素分析,计算调整混杂因素后的社交情绪可疑发育迟缓率比值比(OR)和95%置信区间(CI)。结果被调查地区儿童社交情绪可疑发育迟缓率为24.9%(95%CI:22.9%~27.0%),早产儿社交情绪可疑发育迟缓率为38.8%(95%CI:28.3%~49.4%)。多因素Logistic回归分析显示,社交情绪可疑发育迟缓的危险因素有:早产(aOR=2.58,95%CI:1.44~4.60)、男孩(aOR=1.70,95%CI:1.27~2.27)、大月龄儿童(“36~47月龄”aOR=1.63,95%CI:1.00~2.60;“48~59月龄”aOR=2.12,95%CI:1.27~3.54)、家庭人均纯收入较低(“低于3000元”aOR=2.44,95%CI:1.71~3.49;“3000~5999元”aOR=1.64,95%CI:1.14~2.36)、剖宫产(aOR=1.49,95%CI:1.08~2.06)。结论早产是儿童社交情绪可疑发育迟缓的危险因素之一,应当及时关注、随访被调查地区儿童尤其是早产儿的社交情绪发育情况,以便进行早期干预。

Objective To understand the prevalence of suspected developmental delay(SDD)in social-emotional development among children aged 3-59 months in 8 counties of central and western China and to explore its correlation with preterm birth.MethodsA cross-sectional study with probability proportional to size sampling method was conducted in 8 counties of central and western China.A total of 1927 children aged 3-59 months and their caregivers in Xinjiang,Qinghai,Ningxi and Jiangxi were investigated from Oct,2016 to Jan,2017.The parent-completed Ages and Stages Questionnaires:Social-Emotional,Chinese(ASQ:SE-C)were used to detect the SDD in social-emotional development.Multivariate Logistic regression model was applied to estimate the odds ratios and 95%confidence intervals(CI)of the prevalence of SDD after adjustments for potential cofounding factors.ResultsThe prevalence of SDD in social-emotional development was 24.9%(95%CI:22.9%-27.0%),38.8%(95%CI:28.3%-49.4%)as for the preterm children.The risk factors of SDD in social-emotional development included preterm birth(aOR=2.58,95%CI:1.44-4.60),boys(aOR=1.70,95%CI:1.27-2.27),older children(“36-47 months”aOR=1.63,95%CI:1.00-2.60;“48-59 months”aOR=2.12,95%CI:1.27-3.54),low family income(“lower than 3000 yuan per year-person”aOR=2.44,95%CI:1.71-3.49;“3000-5999 yuan per year-person”aOR=1.64,95%CI:1.14-2.36)and cesarean delivery(aOR=1.49,95%CI:1.08-2.06).ConclusionPreterm birth is a risk factor of suspected developmental delay in social-emotional development.Further attention should be paid to children of surveyed areas especially to the preterm children to implement early interventions.