Table of Content

10 March 2025, Volume 33 Issue 3

Previous Issue   

Professional Forum

Focusing on key issues in caregiving for infant and toddlers and family nurturing guidance

XU Mengxue, ZHANG Yuning, GUAN Hongyan

2025, 33(3):  238-243.  DOI: 10.11852/zgetbjzz2025-0129

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The period from 0 to 3 years of age is the most rapid phase of brain development in infants and young children, making it a critical window for early intervention. Providing high-quality family nurturing care is a crucial means of maximizing the early developmental potential of infants and toddlers. Enhancing the capacity of families in caregiving has become a key strategy for promoting the physical, mental, and comprehensive development of children aged 0 to 3. Professionals in child healthcare at maternal and child health institutions and community health centers play a significant role in guiding families in infant and toddler care. This article discusses key issues in the practice and guidance of family caregiving for infants and toddlers, emphasizing the importance of responsive care throughout the nurturing process, the mental health of caregivers, the early cultivation of socio-emotional skills in infants and toddlers, and the risks associated with screen exposure. It calls for increased attention from both primary heath care professionals and the broader society to collectively enhance the capacity of families in providing care for infants and toddlers.

Integrating "love, talk, play, read" into nurturing care

SHAO Jie

2025, 33(3):  244-247.  DOI: 10.11852/zgetbjzz2025-0135

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The early years of life, particularly ages 0 - 8 (at least 0 - 3), have a profound influence on lifelong health and achievements. Parenting plays a critical role in shaping a child's potential. Integrating the five key nurturing care strategies for early childhood development, especially "responsive caregiving" and "early learning opportunities", into daily routines is both an art and an essential practice for parents and caregivers.The "love, talk, play, read" approach encourages that caregivers show positive emotions and love to their children, interact with them, follow children's lead and enter their world, help children focus and share their experiences, help children understand their surroundings, broaden their horizons, praise and appreciate their efforts, and guide them in learning rules, boundaries, and values. This article explores how to incorporate "love, talk, play, read" into parenting, enabling families and children to grow healthily together through interactive play and communication.

Original Articles

Research on relationship between preschoolers' shyness and social skills under the based on a moderated mediation model

SHAO Yuqi, YAO Mengmeng, GENG Lina, LI Yanwei, CHI Xia

2025, 33(3):  248-253.  DOI: 10.11852/zgetbjzz2024-0683

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Objective To explore the impact of shyness traits on young children's social skills, the mediating role of emotion regulation, and the moderating role of executive functions, so as to provide insights for improving social skills in early childhood. Methods In December 2021, a questionnaire survey was conducted among parents of 818 children aged 3 to 6 from three kindergartens in Nanjing using the Child Behavior Checklist, Emotion Regulation Checklist, Behavioral Rating Inventory of Executive Function, and Social Skills Rating System. The PROCESS 4.0 plugin in SPSS 27.0 was used to verify the moderated mediation model. Results 1) Shyness traits were significantly negatively correlated with children's social skills(β=-0.24, P<0.01). 2) Emotion regulation partially mediated the relationship between children's shyness traits and social skills, accounting for 14.71% of the mediation effect(β=-0.29, P<0.01). 3) Executive functions moderated the direct path between shyness traits and social skills(β=0.29, 95%CI: 0.20 - 0.37, P<0.01) as well as both the antecedent and consequent paths of the mediation effect of emotion regulation(antecedent path: β=0.15, 95%CI: 0.07 - 0.24, P<0.01; consequent path: β=0.08, 95%CI: 0.01 - 0.15, P<0.01). Conclusions There is a moderated mediation effect between shyness traits and social skills, with emotion regulation serving as a mediator in this relationship. Executive functions play a moderating role in the mediation model where shyness traits predict social skills through emotion regulation. By creating game situations that develop executive functions and emotion regulation skills, and improving individuals' cognitive patterns and emotion regulation strategies, the development of young children's social skills may be promoted.

Buffering effect of interactive parenting on cognitive impairment in preschool children caused by persistent parent-child separation after birth

ZHANG Anhui, MA Kai, WANG Yufen, WANG Lingling, SUN Ying

2025, 33(3):  254-258.  DOI: 10.11852/zgetbjzz2024-0933

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Objective To explore the impact of different durations of parent-child separation after birth on the cognitive function of preschool children and the moderating effect of interactive parenting, in order to promote the healthy development of cognitive function in left-behind children. Methods In September 2021, 450 preschool children aged 0 - 6 years were recruited from a rural area in Wuhu City for cognitive development assessment. Parent and primary caregiver questionnaires were used to assess parent-child separation and its timing(separation only before 3 years old, separation only after 3 years old, continuous separation from birth), as well as the level of interactive parenting(number of books at home, storytelling to children, reading, singing, playing games, and counting with children). Parent-child separation was defined as the child being separated from their parents for more than 6 months per year. The cognitive function of preschool children was assessed using the Chinese version of the Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition(WPPSI-Ⅳ). Results The mean age of the participating children was (4.60±0.56) years old, with 214 boys(47.6%).31.3%(141/450) preschool children had experienced parent-child separation, with 22.7%(32/141) experiencing continuous separation. Compared with children without parent-child separation, preschool children with continuous separation had significantly lower total IQ scores(β=-7.11, 95%CI: -10.83 to -3.39, P<0.001). However, this association was only significant in the low-level group of interactive parenting(≤4 points), and was not observed in the medium-level group(5 points) or high-level group(≥6 points) of interactive parenting. Conclusion Interactive parenting helps to buffer the adverse effects of continuous parent-child separation after birth on preschool cognitive function.

Association of parenting styles, physical activity with sleep problems among 3 - 4 years old children

WU Yan, YE Sunyue

2025, 33(3):  259-264.  DOI: 10.11852/zgetbjzz2024-0545

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Objectives To explore the relationship among parenting styles, physical activity (PA), and sleep problems in 3- to 4-year-old children, so as to provide basis for improving young children's sleep issues. Methods By random sampling, a total of 347 Chinese children aged 3 to 4 years were recruited from 3 common public kindergartens in Jiaxing City from March to April 2022. Sleep problems were defined as a total score >41 on the Children's Sleep Habits Questionnaire. Logistic regression models were used to analyze the relationship between parenting styles and children's sleep problems, and moderation effect models were employed to investigate the moderating role of children's PA. Results Supportive/involved parenting behaviors from both fathers (OR=0.941, 95%CI: 0.903 - 0.980) and mothers (OR=0.938, 95%CI: 0.901 - 0.977) were negatively associated with sleep problems, while hostile/coercive parenting behaviors from both fathers (OR=1.034, 95%CI: 1.002 - 1.067) and mothers (OR=1.038, 95%CI: 1.005 - 1.072) were positively correlated with sleep problems. Children's PA significantly moderated the associations between parents' hostile/coercive or supportive/involved parenting behaviors and children's sleep problems (P<0.05). Conclusions Positive parenting behaviors are associated with reduced sleep problems in 3- to 4-year-old children, while negative parenting behaviors are associated with increased sleep problems. Children's PA moderates the relationship between parenting styles and sleep problems, and engaging in 2 hours of PA daily can buffer the adverse effects of parenting styles on children's sleep problems. Strategies to improve parenting styles and promote PA levels among 3- to 4-year-old children may benefit their sleep.

Analysis of developmental trends in static balance among preschool children based on multicenter research

YANG Zhiyong, HE Yanlu, DONG Wenhong, KUANG Xiaoni, ZHANG Xuejiao, WANG Nianrong, LUO Yan, YANG Lin, ZHU Zonghan, WANG Jian, GUAN Hongyan, TONG Meiling

2025, 33(3):  265-270.  DOI: 10.11852/zgetbjzz2024-0882

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Objective To analyze the trend of static balance ability among preschool children with age and the heterogeneity of age influence on it, in order to provide a basis for the assessment and intervention of early childhood balance ability. Methods Using stratified cluster sampling, a total of 1 605 children aged 3 to 6 years were recruited from eight cities in six administrative regions across China between August 2020 and May 2021. They were divided into seven age groups by half-year increments. The one-leg standing test was conducted under different conditions, and the following durations were recorded: Open-eye left-foot stand(OL), open-eye right-foot stand(OR), closed-eye left-foot stand(CL), and closed-eye right-foot stand(CR). Wilcoxon signed-rank test and Kruskal-Wallis test were used to analyze the trend of static balance development. Quantile regression analysis was used to assess the heterogeneity of age's influence on one-leg standing time. Results The duration of OL(H=424.881), OR(H=383.511), CL(H=216.635), and CR(H=209.754) significantly increased with age(P＜0.001). The differences between OL and CL, and between OR and CR, showed a steady increase each year, with statistically significant differences among age groups (H=355.351, 303.520, P<0.001). At the 0.05 quantile level of one-leg standing time, the regression coefficient for age's influence on one-leg standing time was much lower than that at the 0.50 and 0.95 quantile levels. Conclusions The static balance ability of preschool children improves with age but exhibits age-specific characteristics, with 4 to 5 years being a critical period for balance ability enhancement. Among the sensory mechanisms affecting balance ability,vision plays a more significant role. There is heterogeneity in the influence of age on one-leg standing time among preschool children, and those with poorer ability do not show signs of improvement with age. Therefore, early attention should be paid to the balance ability of preschool children, with timely interventions to promote the development of their motor skills.

Correlation between screen exposure content and family rearing environment in children aged 3 - 6 years old

GAO Xia, CHEN Hao, SUN Yi, LONG Xiang, JIA Yingnan

2025, 33(3):  271-276.  DOI: 10.11852/zgetbjzz2024-0549

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Objective To analyze the correlation between screen exposure content and family rearing environment, in order to provide more reasonable guidance on screen exposure for parents. Methods Caregivers of 353 children aged 3 to 6 years who underwent physical examinations at four maternal and child health hospitals in Shanghai from January to August 2022 were selected as participants. A self-designed Screen Exposure Questionnaire and Family Rearing Environment Scale for Urban Children Aged 3 to 6 Years were used to investigate screen exposure and family rearing environments.The relationship between children's screen exposure content and family rearing environments was analyzed. Results Children's exposure to children's/adult and violent videos significantly varied across different genders, age groups, parental education levels, and family rearing environments(χ²=6.055, 8.145, 9.136, 8.080, 13.327, P<0.05). Similarly, children's exposure to educational/non-educational, animated/real and fast/slow screen-switching videos also differed across different family rearing environments(χ²=14.177, 11.221, 10.544, P<0.05). Boys(OR=1.739, 95%CI:1.112 - 2.718) and poor family rearing environment(OR=2.506, 95%CI:1.173 - 5.356) were risk factors for children's exposure to adult and violent videos(P<0.05). Children aged 3 to 4 years(OR=3.144, 95%CI: 1.472 - 6.715) and those in a poor family rearing environment(OR=4.018, 95%CI: 1.659 - 9.731) were more likely to be exposed to non-educational videos(P<0.05). Children in a poor family rearing environment(OR=0.329, 95%CI: 0.122 - 0.892) were less likely to be exposed to slow screen-switching videos(P<0.05). Conclusion Children's screen exposure content is related to the family rearing environment, and targeted guidance on the rearing environment can help improve children's screen exposure.

Visual motor integration characteristics and association factors in preschool children with spastic cerebral palsy

TANG Xin, LIU Yao, JI Weihua, ZHU Xiao'e, AO Lijuan

2025, 33(3):  277-281.  DOI: 10.11852/zgetbjzz2024-0407

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Objective To assess the visual motor integration(VMI) in preschool children with spastic cerebral palsy(SCP), and to analyze the associated factors, so as to provide reference for the early intervention of SCP. Methods A total of 51 children with SCP who received treatment at the Yunnan Rehabilitation Center from December 2022 to June 2023 and 74 typically developed children attending the Kunming Medical University Kindergarten during the same period were included in the study. All children completed the Beery-Buktenica Developmental Test of VMI(Beery VMI), visual perception(VP) test, and motor coordination(MC) test. Demographic characteristics were collected through a survey questionnaire, and the factors related to VMI in children with SCP were analyzed. Results There were significant differences in Beery VMI, VP, and MC tests scores in typically developed children among different age groups(F=65.458, 23.526, 45.270, P<0.001), there were no significant differences in children with SCP among different age groups(P>0.05). Compared to typically developed children, except for the 3-year-old age group, the raw scores of VMI in SCP children in other age groups were significantly lower than those of typically developed children(t=3.033, 4.933, 6.014, P<0.05). VMI score in children with SCP was negatively related to Gross Motor Function Classification System(GMFCS) score(r_s=-0.736, P=0.007), and showed strongly positive correlations with VP and MC(r=0.618, r_s=0.743, P<0.001). Conclusions The VMI, VM, MC of preschool children with SCP are significantly behind those of normal children, suggesting that these three functions are common disabilities and could be considered for inclusion in routine assessment procedures. The VMI of preschool children with SCP is correlated with GMFCS, VP, and MC, providing reference for improving VMI in rehabilitation treatment.

Correlation between fathers' parenting characteristics related to physical activity and preschoolers' physical activity

CHENG Tong, ZHOU Ji, XU Mengjie, XU Mengxue, JIA Ni, WANG Xiaojuan, HE Yanlu, KUANG Xiaoni, ZHANG Xuejiao, WANG Nianrong, LUO Yan, YANG Lin, DONG Wenhong, WU Jianxin, ZHANG Ting, ZHU Zonghan, WANG Jian, TONG Meiling, GUAN Hongyan

2025, 33(3):  282-287.  DOI: 10.11852/zgetbjzz2025-0028

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Objective To investigate the influence of fathers and their parenting characteristics related to physical activity on the physical activity levels of preschool children, in order to provide a basis for enhancing the role of fathers in physical activity interventions. Methods From October 2020 to January 2021, a convenience cluster sampling method was employed to select 40 kindergartens across 8 cities in China, involving a total of 1 346 preschool children primarily raised by their fathers. Family demographic information was collected, and the Preschool Physical Activity Questionnaire (P-PAQ) was used to investigate the children's physical activity and fathers' parenting characteristics related to physical activity. Results For each additional year in the father's age, the compliance rates of children's outdoor activities and total physical activity decreased by 3% and 2%, respectively (OR=0.97 - 0.98, 95% CI: 0.96 - 1.00, P<0.05). Children whose fathers had a bachelor's degree or higher had screen time and outdoor activity compliance rates that were 1.48 and 1.38 times higher, respectively, than those whose fathers had less than a bachelor's degree (OR=1.38 - 1.48, 95% CI: 1.07 - 1.98, P<0.05). Children with fathers of normal body mas index (BMI) had moderate-to-vigorous physical activity and total physical activity compliance rates that were 1.33 and 1.28 times higher, respectively, than those with overweight or obese fathers (OR=1.28 - 1.33, 95% CI: 1.02 - 1.67, P<0.05). For each additional point in the father's physical activity parenting beliefs, the compliance rates of children's outdoor, moderate-to-vigorous, and total physical activity increased by 5% - 10% (OR=1.05 - 1.10, 95% CI: 1.00 - 1.15, P<0.05). For each additional point in the father's physical activity behavior, the compliance rates of children's outdoor time and moderate-to-vigorous physical activity increased by 4% (OR=1.04, 95% CI: 1.01 - 1.07, P<0.05). Conclusions Fathers' parenting characteristics related to physical activity may influence the physical activity levels of preschool children. Fathers with normal BMI, positive physical activity parenting beliefs, and good physical activity behaviors could serve as effective intervention strategies to improve the physical activity levels of preschool children.

Review

Application of responsive caregiving in infant nurturing care

FENG Weixi, ZHU Lingfeng

2025, 33(3):  288-292.  DOI: 10.11852/zgetbjzz2024-0252

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Infancy and toddlerhood are critical periods for brain development in children.Nutritional feeding and scientific care are the material basis to ensure their quality of life and effective measures to promote their healthy growth. As a scientific way of care, responsive care aims to identify the needs signals of infants and toddlers and make timely and correct responses through the interactive communication and keen observation between caregivers and infants, which is conducive to improving the quality of parenting.This paper systematically reviews the current situation of responsive care research at home and abroad, analyzes its connotation, theoretical basis, guiding basis, implementation effect and challenges, and aims to provide theoretical basis for clinical care practice of infants and young children.

Advances in research on parenting burnout domestically and internationally

ZHANG Qin, ZHAO Mei

2025, 33(3):  293-297.  DOI: 10.11852/zgetbjzz2024-0171

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Parental burnout refers to a set of negative symptoms resulting from parental role and long-term parenting stress. Scholars both domestically and internationally have conducted a series of studies revolving around parenting burnout, exploring its concept, measurement tools, causes, impacts, and consequences.This study systematically reviews the causes of parenting burnout and conducts an in-depth analysis of its effects on the physical and mental health of children, proposing corresponding intervention measures, in order to provide valuable insights for preventing parental burnout, alleviating children's behavioral issues, and enhancing the quality of parenting and children's well-being in families.

Progress of auditory processing in children with developmental dyslexia

LI Tingyu, LYU Jinxia, CHI Xia, HONG Qin

2025, 33(3):  298-302.  DOI: 10.11852/zgetbjzz2024-0205

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Developmental dyslexia is a common type of learning disability characterized by slow reading speed, difficulties in word recognition and spelling. This neurodevelopmental disorder cannot be explained by sensory or neurological impairment, lack of educational opportunities and learning motivation, or lower intelligence. Studies have shown that children with this condition often have auditory processing defects, which may be masked by good peripheral hearing and therefore often overlooked. This article summarizes and discusses the auditory processing characteristics of children with developmental dyslexia from multiple aspects, including neuroanatomical structures, behavioral studies, electrophysiology, intrinsic neural mechanisms, and genetic phenotypes, so as to provide scientific basis for early identification and rehabilitation intervention.

Research progress on the effects of prenatal caffeine exposure on children's growth and development

WEI Yumeng, YANG Fan

2025, 33(3):  303-307.  DOI: 10.11852/zgetbjzz2024-0148

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Prenatal caffeine exposure (PCE) refers to the consumption of caffeine-rich substances including tea, coffee, cola, energy drinks, and chocolate, and certain caffeine-containing cold and pain medications during pregnancy. Current epidemiological and animal studies have revealed that even a safe dose of caffeine during pregnancy might lead to adverse effects on offspring. Improper PCE, considered an adverse environmental factor during early development, might correlate with an elevated risk of various diseases in both childhood and adulthood. Studies suggest an association between maternal caffeine intake during pregnancy and an increased likelihood of offspring overweight/obesity, as well as cognitive and behavioral developmental disorders, although this association remains debated. This article reviews the impact of PCE on the long-term growth and development of children, and summarizes the potential mechanisms, offering clinical insights into the etiology of childhood overweight, obesity, and cognitive and behavioral developmental disorders.

Research progress on the influencing factors of responsive feeding in infant from socio-ecological perspective

LIU Nian, XU Yuying, ZHANG Xi, YU Liping

2025, 33(3):  308-312.  DOI: 10.11852/zgetbjzz2024-0033

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Responsive feeding practices, now an integral part of global infant and young child nutrition strategies, play an essential role in fostering early childhood development. Nonetheless, it is influenced by many factors in the implementation process. Based on the theory of social ecosystem, this systematic review examines the multifaceted determinants of responsive feeding in infants and young children across three interconnected domains: Individual characteristics of the child, caregiver and familial factors, as well as broader societal environmental and policy contexts, so as to provide evidence-based basis for formulating effective intervention measures in the future.

Meta Analysis

Scoping review of early intervention research in families of children with autism spectrum disorder

HAO Danshi, LIU Shu, QIN Yangyang, ZHONG Yuan, YANG Yanming

2025, 33(3):  313-318.  DOI: 10.11852/zgetbjzz2024-0202

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Objective To conduct a scoping review of family-based early intervention studies in autism spectrum disorder (ASD), and to determine the essential components of early family interventions, so as to provide reference for clinical practice. Methods A systematic search was performed across PubMed, CINAHL, Embase, WOS, Cochrane Library, SinoMed, China National Knowledge Infrastructure, Wanfang Medical Database, and VIP Information Chinese Science and Technology Periodical Database, with the time span ranging from database inception to February 2024. Results Fourteen articles were included in the synthesis. Predominantly, interventions were grounded in structured training methodologies, the Denver Model of Early Intervention, Picture Exchange Communication System (PECS). Intervention strategies encompassed online guidance, parent-child play interactions, and naturalistic scenario interventions. The duration of interventions typically spanned three to four months. Outcome measures entailed assessments of the child's symptoms, abilities, and parental evaluations. Findings indicated that family-based early interventions facilitated skill development in children with ASD and improved parental psychological well-being; however, inconsistencies in intervention intensity, evaluation metrics, and completion rates were evident. Conclusions Research on family-based early interventions for ASD is still evolving. Future endeavors should focus on refining assessment frameworks, intensifying intervention efforts, leveraging internet technologies, and devising scientifically sound and efficacious family intervention protocols.

Clinical Research

Relationship between responsive caregiving and social support in infants and young children

XU Yuying, GUO Chenming, WANG Lei, DONG Xueli, WANG Suqing, LU Yaping, YU Liping

2025, 33(3):  319-323.  DOI: 10.11852/zgetbjzz2024-0091

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Objective To explore the relationship between the level of responsive care and caregivers' social support, so as to provide a theoretical basis for improving the level of responsive care for infants and young children. Methods A cross-sectional survey was conducted among 896 infants and young children who received health examinations in the child health clinic of Wuchang District Maternal and Child Health Hospital in Wuhan from March 2023 to January 2024. General information questionnaire, Social Support Scale, and Infant and Young Child Responsive Caregiving Scale were used for the survey. The correlation between caregivers' social support and responsive care for infants and young children was analyzed, along with its influencing factors. Results The level of responsive care was correlated with children's health status (Z=-4.127), child insurance (H=10.873), paternal education level (H=9.092), maternal education level (H=9.254), family's per capita monthly income (H=9.642), and marital relationship (H=44.810) (P<0.05). There was a significant positive correlation between responsive care for infants and young children and social support (r=0.176, P<0.01). Multivariate linear regression analysis showed that after controlling for demographic factors, social support still had a significant positive effect on the level of responsive care for infants and young children (β=0.206, 95%CI: 0.08 - 0.25, P<0.01). Conclusions Social support affects the level of responsive care in infants and young children. Health care professionals should provide caregivers with guidance on nurturing care to improve the level of responsive care for infants and young children.

Application of family-based parent-child training in early intervention of late-preterm infants

ZHOU Shan, XU Suxiang

2025, 33(3):  324-328.  DOI: 10.11852/zgetbjzz2024-0057

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Objective To explore the effects of family-based parent-child training on the growth and neuropsychological development of premature infants, in order to provide clues for enriching the specific implementation methods of early intervention for premature infants. Methods A total of 87 late-preterm infants aged 0 - 3 months corrected age, who visited the outpatient department of premature infants at Kunshan Institute of Maternal and Child Health Care from October 2022 to May 2023, were selected as study subjects, and were divided into two groups based on the random number table method. The control group (n=48) received routine follow-up, while the intervention group (n=39) participated in regular family-based parent-infant training courses in addition to routine follow-up. The neuromotor development at 3 months corrected age, height, weight, head circumference, and neuropsychological development at 6 months corrected age, as well as the family rearing environment, were compared between the two groups. Results At 6 months corrected age, there was no statistically significant difference in physical development between the intervention group and the control group (P>0.05).The total developmental quotient (DQ) score of Griffiths Scale in the intervention group was significantly higher than that of the control group(t=3.632, P=0.001). Although the raw scores in all domains of the Griffiths Scale were also higher in the intervention group than in the control group, the differences were not statistically significant (P>0.05). The scores of all dimensions and the total score of the family rearing questionnaire were higher in the intervention group than in the control group, but only the difference in the interpersonal interaction/feeding dimension score was statistically significant (t=3.516, P=0.001). Conclusion Family-based parent-child training can not only promote the comprehensive development of late-preterm infants in terms of motor skills, language, and cognition, but also effectively improve the family rearing environment and enhance parental caregiving abilities, thereby better promoting the early healthy development of premature infants.

Application of "Internet+" remote jaundice monitoring in neonatal jaundice follow up

SHI Yidan, ZHANG Xinhua

2025, 33(3):  329-334.  DOI: 10.11852/zgetbjzz2024-0416

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Objective To compare the differences between the "Internet+" follow-up model and the traditional follow-up model in the follow-up of neonatal jaundice, and to explore the clinical significance of conducting "Internet+" remote jaundice monitoring in reducing the incidence of severe hyperbilirubinemia and kernicterus. Methods Newborns discharged from the obstetrics and neonatology departments of Shanxi Provincial Children's Hospital between January 2022 and October 2023 who required follow-up for jaundice were selected into this study, and were divided into two groups based on the follow-up method: The "Internet+" follow-up model group (experimental group, n=100) and the traditional follow-up model group (control group, n=100). The follow-up results of both groups were compared. Results A total of 146 participants the follow up, with 89 in the experimental group and 57 in the control group. The dropout rates were 11% in the experimental group and 43% in the control group, with the control group's dropout rate significantly higher than that of the experimental group (χ²=25.988, P<0.001). The age at which the first remote transcutaneous bilirubin (TcB) measurement was taken in the experimental group (4.0 days) was significantly earlier than the age at which the first return hospital TcB measurement was taken in the control group (8.0 days) (Z=-5.984, P<0.001). The initial TcB value in the experimental group (9.7mg/dL) was significantly lower than that in the control group (12.3mg/dL) (t=4.330, P<0.001). On average, the number of remote TcB measurements per person in the follow-up period was 44 times, significantly higher than the average of 4 times per person when coming to the hospital for re-examination in the control group (Z=-9.679, P<0.001). The incidence of hyperbilirubinemia in the experimental group (19,21.3%) was significantly higher compared to control group (22, 38.6%) (χ²=5.118, P=0.024); there were 3 cases (3.4%) of severe hyperbilirubinemia in the experimental group, significantly lower than that in the control group(7,12.2%) (χ²=4.323, P=0.038). Factors affecting follow-up compliance included maternal education level (OR=2.578, 95%CI:1.338 - 4.969, P＜0.01) and the follow-up model (OR=2.842, 95%CI:1.326 - 6.091, P＜0.01). Conclusion The "Internet+" remote follow-up model is non-invasive, simple, and reliable, capable of improving compliance with follow-ups and having significant importance in preventing hyperbilirubinemia.

Influencing factors of bone metabolism indicators in premature infants

YANG Dong, BAI Ruimiao, YANG Yunfan

2025, 33(3):  335-339.  DOI: 10.11852/zgetbjzz2024-0410

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Objective To analyze factors related to bone metabolism indicators in premature infants, so as to provide clinical evidence for early detection and prevention of neonatal metabolic bone disorders. Methods A total of 189 preterm infants who met the inclusion criteria from January 1st to December 1st, 2022, at the Northwest Women's and Children's Hospital were collected for retrospective analysis. The correlations of gestational age, birth weight with bone metabolism indicators at birth was analyzed, including serum calcium, phosphorus, 25(OH)D, alkaline phosphatase (ALP). For high-risk groups of metabolic bone disease of preterm (MBDP) infants (gestational age <32 weeks), the impact of different perinatal factors on the levels of serum calcium, phosphorus, 25(OH)D, and ALP at birth was analyzed. Results Serum calcium in preterm infants was positively correlated with gestational age and birth weight (r=0.364, 0.311, P<0.05), while serum ALP was negatively correlated with gestational age and birth weight (r=-0.294,-0.261, P<0.05), and serum phosphorus was positively correlated with birth weight (r=0.186, P<0.05). In the study of high-risk MBDP groups (gestational age <32 weeks), the serum phosphorus levels in the cesarean section group, IUGR group, asphyxia/low Apgar score group, and pregnancy-induced hypertension group were lower than those in the natural labor group, non-IUGR group, non-asphyxia/low Apgar score group, and non-pregnancy-induced hypertension group (t=2.128, 4.718, 2.543, 4.134, P<0.05). ALP in the IUGR group and pregnancy-induced hypertension group was lower than that in the non-IUGR group and non-pregnancy-induced hypertension group (Z=-1.846,-2.844, P<0.05); serum 25(OH)D level in the gestational diabetes group was higher than that in the non-gestational diabetes group (Z=-2.410, P<0.05). Multiple linear regression analysis suggested that IUGR wassignificantly associated with serum phosphorus level in high-risk infants (β=-0.231, P<0.05), and pregnancy-induced hypertension wassignificantly associated with ALP level(β=-60.360, P<0.05). Conclusions Bone metabolism markers in preterm infants are significantly correlated with gestational age and birth weight. For high-risk MBDP infants (gestational age < 32 weeks), IUGR is an risk factor for abnormal serum phosphorus levels, and hypertensive disorders of pregnancy are influencing factors for reduced ALP levels. Targeted interventions based on maternal conditions are recommended to reduce the incidence of MBDP.

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Efficacy of intervening with active head control training at different times on the recovery and gross motor development of infants with torticollis

WANG Chao, LIU Shuqi, DONG Miaomiao, LI Xiang, WANG Man

2025, 33(3):  340-344.  DOI: 10.11852/zgetbjzz2024-0342

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Objective To evaluate the intervention effect of active head control training in different periods in children with torticollis, so as to provide scientific basis for promoting the prognosis and gross motor development of these children. Methods A total of 70 children with torticollis who visited the Second Rehabilitation Clinic of Shengjing Hospital of China Medical University from January 2022 to December 2023 were selected as the study subjects. Based on the timing of the introduction of head control training, the children were divided into an observation group and a control group, with 35 children in each group. Both groups underwent passive stretching exercises for the shortened sternocleidomastoid muscle. The control group received active head control training when the child could actively lift their head to 45° in prone position and maintain the position for ≥30s. The observation group received active head control training from the beginning of the first treatment. Neck passive range of motion (rotation to the affected side and lateral flexion to the unaffected side), the ratio of sternocleidomastoid muscle thickness between the two sides, and gross motor function were compared between the two groups before and after training. Results After training, the observation group significantly outperformed the control group in terms of the Test of Infant Motor Performance (TIMP) score (96.26±10.01 vs. 89.97±8.96, t=2.769, P<0.05) and evoked items score (86.80±9.29 vs. 80.91±7.95, t=2.847, P<0.05). Further analysis showed that the differences in TIMP total score (49.20±10.83 vs. 43.54±7.87, t=2.500, P<0.05) and evoked items score (43.66±10.30 vs. 38.37±7.33, t=2.474, P<0.05) between pre- and post-training were significantly greater in the observation group compared to the control group. Conclusion Early intervention with active head control training can promote gross motor development and symmetrical contraction of bilateral sternocleidomastoid muscles in children with torticollis.