摘要
目的 探讨影响农村30月龄幼儿行为发育的相关因素.方法 于2006年7月至2008年8月在陕西省长武县及彬县选取30月龄的幼儿.纳入标准：出生于2004年1月至2006年2月的单胎活产儿,幼儿母亲曾完整参加过＂孕期微营养素干预预防新生儿低出生体重及早产＂的社区干预性研究,排除有明显生理畸形或其他先天缺陷及不能完成问卷调查、体格检查的幼儿.共纳入977名30月龄幼儿.调查幼儿的喂养、疾病、体格发育及免疫接种情况,并运用贝利婴幼儿发展量表对幼儿的行为表现进行测评,用一般线性模型对可能的混杂因素进行调整,采用方差分析探讨30月龄幼儿行为发育的影响因素.结果 本研究中幼儿的月龄为（30.6±0.6）月;出生体重为（3199.1±405.9）g.调整母亲分娩年龄、父母亲文化程度和职业、家庭经济、家庭孩子数后,母亲孕期暴露于有毒化学品的幼儿活动性得分为（-0.179±0.961）分,专注性得分为（-0.177±1.099）分,均低于母亲孕期未暴露于有毒化学品的幼儿[（0.058±1.006）分,P=0.001;（0.057±0.960）分,P=0.003];母亲孕期服用药物的幼儿持久性行为得分为（0.070±1.000）分,低于母亲孕期未服用药物的幼儿[（0.085±1.006）分,P=0.017].小于胎龄幼儿专注性得分为（-0.198±1.063）分,低于正常胎龄出生的幼儿[（0.043±0.981）分,P=0.007].低出生体重幼儿专注性得分为（-0.389±1.285）分,低于正常出生体重的幼儿[（0.021±0.984）分,P=0.034].调整了分娩孕周、幼儿测查时的月龄、母亲分娩年龄、父母亲文化程度和职业、家庭经济、家庭孩子数、幼儿主要看护人后,早期患病幼儿的活动性得分为（-0.049±0.992）分,低于未患病的幼儿[（0.207±1.011）分,P=0.001].患有佝偻病体征的幼儿,其运动协调性得分为（-0.218±0.896）分,低于体征正常的幼儿[（0.031±1.011）分,P=0.013].母亲孕期补充微量营养素≥180片的幼儿的专注性得分为（0.066±0.966）分,高于孕期微量营养素补充〈180片的幼儿[（-0.062±1.027）分,P=0.043];早期充足优质蛋白质补充的幼儿活动性得分为（0.078±1.013）分,高于早期补充优质蛋白质不足的幼儿[（-0.254±0.924）分,P〈0.001];早期矿物质和维生素足量添加的幼儿专注性得分为（0.496±0.872）分,高于早期矿物质及维生素补充不足的幼儿[（0.001±0.997）分,P=0.033].结论 母亲在孕期对微量营养素的补充以及婴幼儿早期合理的营养添加影响幼儿的行为发育.
Objective To explore the relevant factors of behavioral development among 30 month old infants in rural area, Shaanxi Province. Methods The behavioral development among 977 infants aged 30 month old was evaluated in Changwu and Binxian of Shaanxi province from july 2006 to August 2008. The inclusion criteria included single live birth between january 2004 and February 2006, mother had participated in a community based intervention study named＂Impact of multi micronutrient supplementation during pregnancy on low birth weight and premature delivery＂. Infants who had obvious deformity or other birth defects, infants who could not complete the questionnaire survey, physical examination were excluded from the study. The self designed questionnaire was used to investigate the information of feeding patterns, disease status, physical development, and immunization status of the infants, and their behavioral development were assessed by Bayley scales of infant development （BSID）. General Linear Model was used to adjust the possible confounding factors, and the analysis of variance was performed to explore the effects on the behavioral development among infants aged 30 month old. Results Among the infants in the study, the average age was （30.6 ± 0.6） months old, the mean birth weight was （3199.1 ± 405.9）g. After adjusted the mothers age of delivery, educational level and occupation of the parents, family ecnomic conditions and the number of children, infants whose mother exposed to toxic chemicals during pregnancy had lower score in activity （-0.179 ± 0.961） and lower score in concentration （-0.177 ± 1.099） compared with infants with unexposed mother （0.058 ± 1.006, P=0.001; 0.057 ± 0.960, P=0.003）. Similarly, infants whose mother took drugs during pregnancy had lower score in persistent behaviors （-0.070±1.000） compared with infants whose mother did not（0.085±1.006, P=0.017）. Compared with normal birth infants（0.043±0.981, P=0.007;0.021±0.984, P=0.034）, infants less than gestational age and low birth weight had lower score in concentration（-0.198 ± 1.063 and-0.389 ± 1.285, respectively）. After adjusted the delivery gestational age of mothers, the months of infants, the mothers age of delivery, educational level and occupation of the parents, family ecnomic conditions, the number of children, and the main orderlies of infants, the score of activity of infants suffered from diseases in early month age was-0.049 ± 0.992, which was lower than those who did not（0.207±1.011, P=0.001）. The infants with Rickets signs had lower score in motor coordination （-0.218±0.896） than normal infants （0.031±1.011, P=0.013）. Infants whose mother with adequate micronutrient supplementation in pregnancy had higher score in concentration （0.066±0.966） than those whose mother with insufficient supplementation （-0.062 ± 1.027, P=0.043）. Furthermore, infants with fine protein added and minerals and vitamins added had higher score in activity and concentration compared with those insufficient, who scored 0.078 ± 1.013 and 0.496 ± 0.872 （-0.254 ± 0.924, P〈0.001;0.001 ± 0.997, P=0.033）, respectively. Conclusion Micronutrient supplementation during pregnancy and reasonable nutrition added during childhood could affect behavioral development among infants.
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2017年第7期628-634,共7页
Chinese Journal of Preventive Medicine
基金
国家自然科学基金（81373019）
关键词
婴儿
行为
营养状况
横断面研究
Infant
Behavior
Nutritional status
Cross sectional studies
