目的 了解学龄前儿童体重从出生至学龄前变化情况,探索其与神经心理发育的关系,为儿童全周期营养管理及神经心理早干预提供参考依据。方法 2022年10月—2023年5月,采用多阶段分层抽样,选取云南省10所幼儿园的1 140名儿童为研究对象。采用标准化法测量儿童体重,查阅出生证明与《儿童保健手册》收集相关资料,使用0~6岁儿童发育行为评估量表对所有儿童进行神经心理发育评估,计算发育商(DQ),并分析儿童出生至学龄前体重变化与发育迟缓(DQ<80)的关系。结果 1)1 140名儿童中,低体重检出率为4.21%,超重/肥胖率为29.56%,低出生体重率为5.44%。2)神经心理发育迟缓总检出率为2.02%,其中低体重儿童神经心理发育迟缓检出率为6.25%,超重/肥胖儿童为1.48%。低出生体重儿童神经心理发育迟缓检出率(6.46%)显著高于正常出生体重儿童(1.76%)(P＜0.05)。3)不同体重(χ2=22.53)和不同体重变化的学龄前儿童社会行为能区发育迟缓检出率比较,差异均有统计学意义(P＜0.05);低体重儿童该能区发育迟缓检出率(16.67%)显著高于正常体重儿童(5.03%)(P＜0.05)。4)logistic回归分析显示,与体重持续正常儿童比较,正常及低出生体重发展为低体重儿童社会行为能区出现发育迟缓风险更高(OR=3.09,95%CI:1.31~7.31),正常及低出生体重发展为超重/肥胖儿童该能区出现发育迟缓风险降低(OR=0.33,95%CI:0.14~0.79)(P＜0.05)。结论 从出生至学龄前,儿童体重及其变化可能对神经心理发育产生影响。需构建多维度动态监测体系进而制定阶梯式干预方案,并进一步明确其机制。
Abstract
Objective To investigate the changes in body weight from birth to preschool age, and to explore their associations with neuropsychological development, so as to provide a basis for comprehensive nutritional management and early intervention. Methods From October 2022 to May 2023, 1 140 children were selected from 10 kindergartens in Yunnan Province using multi-stage stratified sampling. Preschool weight was measured using standardized methods, and birth weight data were obtained from birth certificates and Child Health Manuals. Neuropsychological development was assessed using the 0 - 6 Year Old Children Developmental Behavior Assessment Scale, and development quotients (DQ) were calculated to analyze the relationship between weight trajectories and developmental delay (DQ<80). Results 1) Among 1 140 children, the prevalence of underweight, overweight/obesity, and low birth weight (LBW) was 4.21%, 29.56%, and 5.44%, respectively. 2) The overall detection rate of neuropsychological developmental delay was 2.02%. Specifically, the rate was 6.25% among children with low weight and 1.48% among children with overweight/obesity. LBW children had a significantly higher rate of neuropsychological developmental delay (6.46%) compared to normal birth weight children (1.76%) (P<0.05). 3) There were statistically significant differences in the detection rates of developmental delay in the social behavior domain among preschool children with different weights (χ2=22.53, P<0.05) and different weight changes (P<0.05). The detection rate of developmental delay in this domain was significantly higher in underweight children (16.67%) than in normal-weight children (5.03%) (P<0.05). 4) Logistic regression revealed that children transitioning from normal/low birth weight into underweight in preschool age had a higher risk of social behavior delay (OR=3.09,95%CI:1.31 - 7.31),whereas patterns developing toward overweight/obesity were associated with a lower risk of delay in the social behavior domain (OR=0.33,95%CI:0.14 - 0.79) (P<0.05). Conclusions Weight status and its changes from birth to preschool age may influence neuropsychological development. It is critical to establish a multidimensional dynamic monitoring system and implement stepwise intervention strategies for children with abnormal weight changes, so as to further explore the potential mechanisms.
关键词
学龄前儿童 /
不同时期体重 /
体重变化 /
神经心理发育
Key words
preschool children /
weight at different periods /
weight changes /
neuropsychological development
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基金
国家“十三五”科技重大专项 (2018ZX10715006-004);云南省卫生健康委员会医学后备人才培养计划(H-2019004)
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