关键词: 运动发育, 分类树模型, 交互作用, 婴儿

Abstract: Objective To identify the influencing factors of infant motor development,and to explore the potential interactive factors, so as to provide scientific basis for early prediction and targeted prevention of infant motor developmental delay. Methods Data of infants receiving "0~1 motor development screening" at 21 community health service centers in Tongzhou District, from January 1st, 2020 to August 31st, 2021 were collected through the Beijing Maternal and Child Information System.Using the method of nested case-control study, 416 infants with positive screening results were selected as case group, 416 infants with negative screening result were selected into the control group by 1∶1 case-control matching of screening age.Chi-square test, Logistic regression analysis, and Exhaustive CHAID decision tree model were used to explore the influencing factors of infant motor development, the interaction effect was investigated by using the additive and multiplicative interaction models. Results Multivariate Logistic analysis showed that birth weight<2 500g (OR=3.28), cesarean section (OR=1.63), outdoor activity≤ 1h/d (OR=3.07), and no supplementation of vitamin D (OR=2.68) were risk factors for positive screening results of infant motor development (P＜0.01).The Exhaustive CHAID decision tree showed that low birth weight was the primary risk factor for infant with positive screening results, followed by outdoor activity, vitamin D supplementation and delivery.The interaction analysis showed that there was a multiplicative interaction (OR=13.76, 95% CI:1.20 - 158.08) and an additive interaction (RERI=10.22, 95%CI:5.05 - 15.38) between non supplementation of vitamin D and low birth weight on infant motor development with positive screening results. Conclusions Attention should be paid to the early motor development of infants with low birth weight and those born by cesarean section, with emphasis on the dosage of vitamin D supplementation and outdoor activity duration.Moreover, the early screening and hierarchical management of infant motor development should also be strengthened.

Key words: motor development, Exhaustive CHAID decision tree, interaction effect, infant