目的 分析婴儿0～3月龄期间家长睡眠养育行为的特点及影响因素,为婴儿早期睡眠养育行为的预见性指导提供参考依据。方法 采用纵向研究设计于2013-2015年对我国5个城市156例婴儿0～3月龄期间家长睡眠养育行为进行监测,监测时点分别为生后14 d、1、2月龄和3月龄,内容包括夜晚入睡方式、就寝时精神状态和睡床方式。按不同年龄点进行各行为发生率的统计描述和CMH χ2检验,采用广义线性混合模型(GLMMs)进行家长睡眠养育行为的影响因素分析。结果 监测期间观察夜晚婴儿由家长抱着入睡、放在床上轻拍或陪伴入睡和单独自行入睡的比例分别为54.4%、35.9%和9.7%,且随月龄增加,家长抱着入睡的比例呈上升趋势(P＜0.000 1)。婴儿就寝时被放置到床上时已睡着、犯困但未睡着和完全清醒的比例分别为63.7%、28.6%和7.7%,随月龄增加,犯困但未睡着的比例逐渐下降(P=0.000 3)。与家人同床睡眠、同屋但单独小床睡眠、家人抱着睡眠以及单独房间睡眠的比例分别为53.8%、42.4%、2.0%和1.8%,随月龄增加,与家人同床睡眠的比例逐步增多(P＜0.000 1)。父母文化程度均为大学及以上、家庭月收入水平在5 001~8 000元和父亲抑郁情绪对睡眠养育行为有显著影响(OR=0.46,2.55,1.60,0.57,P<0.05或<0.001)。结论 我国婴儿早期家长睡眠养育方式以家长安抚入睡、在已睡着的状态下放置床上睡眠和同床睡眠为主,需要加强预见性指导。
Abstract
Objective To longitudinally examine characteristics and associated factors of parental sleep arrangements for infants aged 0-3 months,in order to provide reference for the predictive guidance of infants' early parental sleep arrangements. Methods This was a longitudinal study of 156 infants with repeated measures from birth to 3 months in 5 cities of China from 2013 to 2015. The parental sleep arrangements were measured at 14 days,1 month,2 months and 3 months after birth. The statistical description and CMH chi-square test were conducted. The generalized linear mixed models were fitted to analyze the associated factors. Results The proportions of infants who fell asleep at night by parents holding,patting or accompanying beside the bed,and alone were 54. 4%,35. 9% and 9. 7%,respectively,and the proportion of falling asleep by holding increased over time (P＜0. 000 1). The proportions of asleep,drowsy but awake and fully awake when the infants were placed on the bed at bedtime were 63. 7%,28. 6% and 7. 7%,respectively,and the proportion of drowsy but awake decreased over time (P=0. 000 3). The proportions of co-sleeping,room-sharing without bed-sharing,slept on parents' arms or backs and in a separate room were 53. 8%,42. 4%,2. 0% and 1. 8%,respectively,and the proportion of co-sleeping increased over time (P＜0. 000 1). Parents' education level of university and above,household income of 5 100~8 000 yuan and father depression were statistically significant on sleep arrangements(OR=0. 46,2. 55,1. 60,0. 57,P<0. 05或<0. 001). Conclusions Parental sleep arrangements for infants in early stage mainly include falling asleep with soothing,putting infants to sleep asleep and co-sleeping,which need to strengthen predictive guidance.
关键词
睡眠 /
养育行为 /
纵向研究 /
0~3月龄婴儿
Key words
sleep /
arrangements /
longitudinal /
0-3 months infants
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