基于门诊的厦门儿童语言发育迟缓相关因素前瞻性队列研究

Prospective cohort study and risk factor analysis of language delay based on outpatient in Xiamen

目的分析厦门地区18~42月龄幼儿语言发育迟缓的社会家庭相关因素。方法采用前瞻性队列研究方法,对2017年7月至2019年7月在厦门大学附属第一医院儿童保健及发育行为学门诊就诊的语言发育迟缓患儿(病例组)及健康对照者(对照组)进行自编问卷及语言发育量表评估调查,病例对照配比为1∶4。应用χ^(2)检验、Logistic回归及广义多因子降维法(GMDR)进行统计学分析,并使用Bonferroni校正法进行校正分析。结果病例组共收集语言发育迟缓患儿126例,男女比例为2.05∶1.00。对照组纳入504例。2组性别、年龄比较差异均无统计学意义。χ^(2)检验分析显示病例组与对照组在母亲文化程度、屏幕时间分布差异有统计学意义(P<0.05/13)。多因素Logistic回归分析提示儿童语言发育迟缓显著的危险因素包括母亲文化程度、母子互动及屏幕时间。GMDR分析显示屏幕时间是儿童语言发育迟缓风险最佳单因素模型;而母亲文化程度及屏幕时间构成有统计学差异的双因素模型,且母子互动纳入了三因素模型。结论屏幕时间和母亲文化程度是厦门儿童语言发育迟缓最主要的危险因素,两者与母子互动存在交互作用,对儿童语言发育迟缓构成影响。

Objective To analyze the social family factors influencing language delay in children with the age ranging from 18 to 42 months in Xiamen.Methods A prospective cohort study was conducted to evaluate children with language delay(case group)and normal controls(control group)in Child Health Clinic and Developmental Behavior Clinic of the First Affiliated Hospital of Xiamen University between July 2017 and July 2019 via a self-made questionnaire and a language development scale,and the case-control ratio was 1∶4.The chi-square test,Logistic regression and generalized multifactor dimensionality reduction(GMDR)were adopted for statistical analysis,and the correction analysis was performed with Bonferroni correction.Results A total of 126 children with language delay were collected in the case group,with the ratio of male to female being 2.05∶1.00.The control group was included 504 cases.There was no significant difference in gender and age between both groups.The chi-square test showed that there were statistical differences in maternal culture and screen time distribution between both groups(P<0.05/13).Besides,the multivariate Logistic regression analysis suggested that significant risk factors for language delay in children included maternal culture,maternal-child interaction,and screen time.The GMDR analysis showed that screen time was the optimal single-mode for children at risk of language delay,while maternal culture and screen time constituted a statistically different two-factor model.Moreover,the marital-child interaction was included into the three-factor model.Conclusions Screen time and maternal culture were the most important risk factors for language delay in children of Xiamen,and both factors would interact with maternal-child interaction,which could exert impacts on language delay in children.