母亲童年期不良经历与儿童神经心理发育的关联研究

Association between maternal adverse childhood experiences and children’s neuropsychologi⁃cal development

目的:分析母亲童年期不良经历(ACE)的流行特点及其对儿童神经心理发育的代际影响,为促进儿童身心健康发展提供科学依据。方法:采用现况研究的方式,以北海市4所幼儿园和2所卫生院门诊作为研究现场,利用简体中文版童年期不良经历国际量表(SC-ACE-IQ)和年龄与发育进程问卷(第3版)(ASQ-3)父母版分别调查学龄前儿童母亲ACEs暴露和儿童神经心理发育水平;通过多因素logistic回归模型,分析母亲ACEs与儿童神经心理发育的关联。结果:母亲报告率最高的前3个ACEs为社区暴力(36.9%)、家庭暴力(32.3%)和身体忽视(22.5%),至少经历过1个ACE者占65.6%;多因素logistic回归分析结果显示:母亲童年期情感忽视经历增加子代解决问题能力(OR=3.8,95%CI:1.2~12.0,P=0.023)、沟通能力(OR=6.9,95%CI:2.3~20.3,P<0.001)和粗大动作(OR=3.8,95%CI:1.5~9.7,P=0.005)发育落后的风险。结论:北海学龄前儿童母亲ACEs暴露具有一定的地方特点,母亲情感忽视可能影响儿童解决问题能力、沟通能力和粗大动作等多个神经心理能力的发育。

Objective:To investigate the prevalence of maternal adverse childhood experiences(ACEs)and the intergenerational effect on children’s neuropsychological development,so as to provide scientific basis for promoting the physical and mental health development of children.Methods:A cross-sectional study was conducted within four kindergartens and two health center outpatient clinics in Beihai City.The maternal prevalence of ACEs and the neuropsychological development of their children were investigated using the simplified Chinese version of the International Scale of Adverse Childhood Experiences(SC-ACE-IQ)and the parental version of Ages&Stages Questionnaires,Third Edition(ASQ-3),respectively.A multiple logistic regression model was applied to analyze the association between maternal ACEs and neuropsychological development of children.Results:The top three most common ACEs for mothers were community violence(36.9%),domestic violence(32.3%),and physical neglect(22.5%),and 65.6%of them experienced at least one ACE.Multiple logistic regression analysis showed that maternal emotional neglect experienced during childhood increased the risk of offspring’s developmental delays in problem-solving(OR=3.8,95%CI:1.2-12.0,P=0.023),communication(OR=6.9,95%CI:2.3-20.3,P<0.001),and gross motor movements(OR=3.8,95%CI:1.5-9.7,P=0.005).Conclusion:Maternal ACEs among preschool children in Beihai has certain local characteristics.Maternal emotional neglect may affect the developmental delays in children,including problem solving,communication,and gross motor movements.