中国学龄前儿童贫血现况与神经心理发育的相关性

Anemia in preschool children in China and its association with neuropsychological development

目的 分析中国学龄前儿童贫血现况及其与不同能区及总体神经心理发育状况的相关关系。方法 数据来源于“中国0~18岁儿童营养与健康系统调查与应用”项目,以14省28个调查点的3 261名2~6岁儿童及其家长为研究对象。儿童相关人口学特征由经过统一培训的调查员进行面对面调查。采用血红蛋白检测方法(Hemocue法)测定儿童全血血红蛋白,儿童的神经心理发育水平由经过培训的儿童保健人员采用《0~6岁儿童发育行为评估量表》(WS/T 580—2017)进行测查。结果 儿童血红蛋白平均水平为(125.23±11.49)g/L,贫血率为10.30%。调整性别、年龄、民族、地区、喂养方式、母孕期情况等混杂因素之后,2~6岁贫血儿童在大运动(β=-2.15,95%CI=-3.89~-0.41)、精细动作(β=-2.46,95%CI=-4.12~-0.79)、适应能力(β=-2.59,95%CI=-4.42~-0.76)、语言(β=-3.65,95%CI=-5.53~-1.78)和社会行为(β=-3.11,95%CI=-4.94~-1.28)5个能区以及全量表(β=-2.79,95%CI=-4.10~-1.49)发育商水平均低于非贫血儿童(P值均<0.05)。结论 2~6岁儿童贫血与其总体发育商以及大运动、精细动作、适应能力、语言和社会行为五大能区发育商水平均呈负相关,建议积极开展学龄前儿童贫血监测、干预工作,进一步提高儿童的神经心理发育水平。

Objective To explore the relationship between anemia and neuropsychological development in various domains among preschool children in China.Methods Data came from the National Nutrition and Health Systematic Survey for children in China,and 3 261 preschool children aged 2-6 years and their parents from 28 sites across 14 provinces were recruited in this study.Parental and child characteristics were obtained by interview-administrated questionnaires.Blood hemoglobin(Hb) concentration was determined by Hemocue method.Neuropsychological development quotients were assessed using the Development Scale for Children Aged 0-6 Years(WS/T 580-2017).Results The average Hb level was(125.23±11.49)g/L and the overall anemia prevalence was 10.30% among preschool children.After adjusting the confounding factors(sex,age,ethnicity,region,feeding mode,maternal status during pregnancy,etc),developmental quotients of gross motor(β=-2.15,95%CI=-3.89--0.41),fine motor(β=-2.46,95%CI=-4.12--0.79),adaptive behavior(β=-2.59,95%CI=-4.42--0.76),language(β=-3.65,95%CI=-5.53--1.78),personal-social behavior(β=-3.11,95%CI=-4.94--1.28) and full-scale(β=-2.79,95%CI=-4.10--1.49) among children with anemia were significantly lower than non-anemic infants(P<0.05).Conclusion Anemia was negatively associated with developmental quotient,as well as five domains of gross motor,fine motor,adaptive behavior,language,and personal-social behavior in preschool children aged 2-6 years.It is suggested to carry out the work of anemia monitoring and intervention in preschool children to further improve their neuropsychological development.