目的 分析“早期”(37～38孕周)出生对儿童发育性协调障碍(DCD)的影响,为确定重点干预和预防人群提供线索。 方法 2018年4-12月纳入上海、马鞍山、台州、海口、厦门、扬州6个城市670所幼儿园的学龄前儿童共46 073例,用小龄发育性协调障碍问卷进行运动协调能力的评估。 结果 研究结果显示,与完全足月儿相比,早期儿总的运动协调能力(67.30±8.90 vs.67.50±8.80)、运动控制能力(22.82±3.08 vs.22.89±3.04)及一般协调性(21.95±3.26 vs.22.03±3.21)等均低于完全足月儿(t=2.174、2.201、2.382,P<0.05)。多因素分析显示在控制了性别、年龄、BMI、父母亲教育程度等潜在混杂因素后,早期儿组女童DCD发生风险较完全足月儿女童增加15.7%(OR=1.157,95%CI:1.001~1.340,P<0.05)。 结论 早期儿可作为DCD早期评估和干预的重点人群,加强早期儿健康管理是“二孩政策”下提高人口素质,节约医疗成本的关键“切入点”之一。
Abstract
Objective To explore the influence of early-term birth (gestational age of 37 to 38 weeks) on developmental coordination disorder (DCD), so as to provide clues for targeting the population receiving intervention and prevention. Methods A total of 46 073 preschool children from 670 kindergartens in Shanghai, Maanshan, Taizhou, Haikou, Xiamen and Yangzhou were enrolled from April to December 2018.The ability of motor coordination was assessed using Little Developmental Coordination Disorder Questionnaire (Little DCDQ). Results The score of total motor coordination (67.30±8.90 vs.67.50±8.80), motor control (22.82±3.08 vs.22.89±3.04) and general coordination (21.95±3.26 vs.22.03±3.21) in early children were lower than those of completely full term children (t= 2.174, 2.201, 2.382, P<0.05).Multivariate analysis showed that after controlling for potential confounding factors such as sex, age and education level of parents, body mass index(BMI), the risk of DCD in girls with early-term birth was 1.157 times higher than that with full-term birth (OR=1.157,95%CI:1.001-1.340, P<0.05). Conclusions Early-term infants should be attached great importance in early assessment and intervention of DCD.Strengthening the healthcare in early-term children would be one of the key points to promote the quality of population and save the medical expenditure under the "two-child" policy.
关键词
发育性协调障碍 /
早期儿 /
儿童
Key words
developmental coordination disorder /
early term /
children
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参考文献
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基金
国家自然科学基金委员会面上项目(81673179); 上海市卫生健康委老龄化和妇儿健康研究专项(2020YJZX0213); 上海市申康医院三年行动计划重大临床研究项目(SHDC2020CR1047B-003)
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