目的 了解嘉兴市0~3岁婴幼儿养育风险现状及家庭养育中存在的问题,为婴幼儿家庭养育提供针对性的家庭养育建议。 方法 采用横断面调查方法,2020年6月1日-7月31日期间在嘉兴地区所有儿童保健门诊体检的0~3岁儿童为研究对象,家长现场用手机填写0~6、6~12、12~36月龄段《养育风险问卷》以及自拟的《家庭基本情况调查问卷》问卷星,根据风险因素给予家庭干预指导。 结果 共调查9 384例0~3岁婴幼儿家庭,养育风险筛查阳性率0~6月龄为30.48%,6~12月龄为39.11%,12~36月龄为45.63%。小于6月龄婴幼儿养育风险因素前三位的是儿童不吃母乳(10.61%)、家中玩具少于3个(8.34%)、儿童至少有2周新生儿期住院史(7.93%);6~12月龄婴幼儿养育风险因素前三位的为没有给儿童吃富含铁的食物 (23.73%)、儿童有营养性疾病(9.64%)、儿童每天吃奶少于3次(6.53%);12~36月龄婴幼儿养育风险因素前三位的为儿童很少每天吃瘦肉或鸡蛋(22.46%)、家中没有图画书(14.85%)、每天很少跟儿童一起玩耍(9.87%)。多因素Logistic回归分析显示父亲学历为高中大专、本科及以上(OR=0.784,95%CI:0.697~0.881;OR=0.701,95%CI:0.599~0.820); 母亲学历为高中大专、本科及以上(OR=0.815,95%CI:0.724~0.917;OR=0.628,95%CI:0.539~0.732)是保护因素;性别男性为危险因素(OR=1.160,95%CI:1.066~1.262)。 结论 现阶段0~3岁婴幼儿普遍存在养育风险,各级专业人员亟需加强健康教育,指导家庭科学养育,规避家庭养育中可避免的风险,保障婴幼儿身心健康。

Objective To know about the current situation of child rearing risks for 0- to 3-year-old children in Jiaxing City as well as the existing problems in family rearing, so as to provide appropriate parenting suggestions for the families with children aged 0 to 3 years. Methods A cross-sectional survey method was used to select children aged 0 to 3 years who took physical examination at all child health clinics in Jiaxing City from June 1st to July 31st, 2020 into this study. Parents used their mobile phones to fill in the Nursing Risk Questionnaire for 0~6, 6~12,12~36 months old children and the self-designed Family Basic Circumstances Questionnaire online. Family intervention guide was given according to the risk factors. Results A total of 9 384 families with 0- to 3-year-old children were investigated. The positive rate of parenting risk screening was 30.48% for 0- to 6-month-old infants, 39.11% for 6- to 12-month-old infants, and 45.63% for 12- to 36-month-old children. The top three parenting risk factors for infants younger than 6 months old included having no breast milk (10.61%), less than 3 toys at home (8.34%), and at least 2 weeks of neonatal hospitalization (7.93%). The top three parenting risk factors for 6- to 12-month-old infants included not giving the iron-rich food (23.73%), nutritional disease (9.64%), and having milk less than 3 times a day (6.53%). The top three parenting risk factors for children aged 12 to 36 months were rarely having lean meat or eggs everyday (22.46%), no picture books at home (14.85%), and rarely playing with children everyday (9.87%). Multivariate Logistic regression analysis showed that the fathers with higher education level(high school or college, bachelor degree and above) (OR=0.784,95%CI:0.697—0.881; OR=0.701, 95%CI:0.599—0.820), mothers with higher education level (high school or college, bachelor degree and above) (OR=0.815, 95%CI:0.724—0.917; OR=0.628, 95%CI:0.539—0.732) were protective factors for positive parenting risk, while male children may have a higher risk for poor parenting(OR=1.160, 95%CI:1.066—1.262). Conclusion At this stage, infants and young children aged 0 to 3 are generally at risk of poor parenting. Professionals at all levels need to strengthen health education urgently, guide family scientific parenting, help to avoid avoidable risks in family parenting, thereby protecting the health of infants and young children physically and mentally.