目的 探讨3岁以下儿童身高/长与神经行为发育之间的关系, 为后续干预提供建议。方法 数据来源于2013年7-9月在山西、贵州六县开展的3岁以下儿童及其看护人的横断面调查, 用非参数检验法和线性回归分析探究儿童身高/长与神经行为发育之间的关系。结果 调查地区3岁以下儿童身高/长标准化得分(HAZ)为-0.73±1.44, 年龄与发育进程问卷(ASQ)Z评分为-0.08(-1.30, 0.77)。1~17月龄身高/长正常组儿童的ASQ-Z评分高于生长不足组0.36, 高于生长迟缓组0.78, 且差异有统计学意义(P＜0.05)。在控制儿童性别、月龄、看护人基本情况、家庭经济状况混杂因素后, HAZ每升高1s, ASQ-Z评分增加0.106s。结论 调查地区儿童身高/长与神经行为发育存在正相关。生长不足是影响低龄儿童神经行为发育的独立因素。生长监测工作中, 要兼顾生长不足和生长迟缓儿童的早期发展指导和促进。
Abstract
Objective To examine the association of linear growth and neurodevelopment among children under 3 years old in impoverished areas of Guizhou and Shanxi Province, in order to provide suggestions fro further intervention. Methods Data were obtained from the cross-sectional study conducted among children under 3 and their caregivers in six poverty-stricken counties from July to September in 2013.Non-parametric test and general linear regression analysis were performed to investigate the association of child linear growth and early neurodevelopment. Results The height-for-age Z-score(HAZ), the median standardized Age and Stages Questionnaire Z score (ASQ Z-score) using the Chinese national norms for children was -0.73±1.44 and -0.08(-1.30, 0.77), respectively.Among children aged 1 to 17 months, the ASQ Z-score for the healthy children group was 0.36 higher than the growth insufficiency group, 0.78 higher than the growth retardation group(P＜0.05).After controlling for children's sex, age, caregivers' age, sex, ethnicity, education, the primary caregivers, family income and household access to internet, the ASQ Z-score increased by 0.106s for every 1s increase in HAZ. Conclusions Child linear growth is positively correlated with early neurodevelopment.Linear growth deficit is an independent risk factor of child neurodevelopment in young children in resource-poor settings of rural China.In the routine growth monitoring and counselling services, the guidance and promotion of early development of children with growth deficits and stunting should be taken into account.
关键词
身高/长 /
神经行为发育 /
3岁以下儿童
Key words
linear growth /
early neurodevelopment /
children under 3 years
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参考文献
[1] 胡燕.儿童营养与线性生长[J].中国儿童保健杂志, 2015, 23(2):113-115.
[2] Black MM, Walker SP, Fernald LCH, et al.Early childhood development coming of age:science through the life course[J].Lancet, 2017, 389(10064):77-90.
[3] Wei Q, Zhang J, Scherpbier RW, et al.High prevalence of developmental delay among children under three years of age in poverty-stricken areas of China[J].Public Health, 2015, 129(12):1610-1617.
[4] 常素英, 何武, 陈春明.中国儿童营养状况15年变化分析——5岁以下儿童生长发育变化特点[J].卫生研究, 2006, 35(6):768-771.
[5] Stevens GA, Finucane MM, Paciorek CJ, et al.Trends in mil d, moderate, and severe stunting and underweight, and progress towards MDG 1 in 141 developing countries:a systematic analysis of population representative data[J].Lancet, 2012, 380(9840):824-834.
[6] 丁心悦, 于冬梅, 赵丽云.中国婴幼儿生长迟缓患病现况及与喂养行为关系[J].中国公共卫生, 2018, 34(5):665-668.
[7] Sudfeld CR, Mccoy DC, Danaei G, et al.Linear growth and child development in low- and middle-income countries:a meta-analysis[J].Pediatrics, 2015, 135(5):1266-1275.
[8] Sanou AS, Diallo, AH, Holding P, et al.Association between stunting and neuro-psychological outcomes among children in Burkina Faso, West Africa[J].Child Adolesc Psychiatry Ment Health, 2018, 12(1):30.
[9] Bogale A, Stoecker BJ, Kennedy T, et al.Nutritional status and cognitive performance of mother-child pairs in Sidama, Southern Ethiopia[J].Matern Child Nutr, 2013, 9(2):274-284.
[10] 魏梅, 卞晓燕, Squires J, 等.年龄与发育进程问卷中国常模及心理测量学特性研究[J].中华儿科杂志, 2015, 53(12):913-918.
[11] Council on Children with Disabilities, Section on Developmen-tal Behavioral Pediatrics, Bright Futures Steering Committee, et al.Identifying infants and young children with developmental disorders in the medical home:an algorithm for developmental surveillance and screening[J].Pediatrics, 2006, 118(1):405-420.
[12] 姚国英, 卞晓燕, Squires J, 等.年龄与发育进程问卷中文版的婴幼儿发育筛查界值标准研究[J].中华儿科杂志, 2010, 48(11):824-828.
[13] World Health Organization.Developmental difficulties in ea rly childhood:prevention, early identification, assessment and intervention in low- and middle-income countries:a review[R].Genva:WHO, 2012.
[14] WHO Multicentre Growth Reference Study Group.WHO child growth standards:methods and development[M].2006, World Health Organization:Geneva.
[15] 杨玉凤.重视营养素对儿童神经发育及行为的调控影响[J].中国儿童保健杂志, 2008, 16(3):249-250.
[16] 刘倩筠, 林穗方, 郭勇.家庭喂养行为对婴儿早期发育的影响[J].中国儿童保健杂志, 2010, 18(10):74-75.
[17] 国务院妇女儿童工作委员会办公室, 国家统计局, 联合国儿童基金会.中国儿童发展指标图集[R].北京:联合国儿童基金会, 2018.
[18] 邓文娇, 王虹, 蔡瑾瑜.采用ASQ-3对2246例深圳市3～4月龄婴儿发育筛查结果的分析[J].华中科技大学学报:医学版, 2016, 45(4):454-457.
[19] 易燕, 田小琼, 王永兰.运用年龄与发育进程问卷调查十堰市儿童神经精神发育状况[J].现代中西医结合杂志, 2014, 23(14):1544-1546.
基金
联合国儿童基金会“儿童早期综合发展”项目(0860/A0/05/502)
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