631名儿童家庭养育环境与儿童神经心理发育水平的相关分析

Correlation of family rearing environment and neuropsychological development level in 631 children

摘要

目的 了解家庭养育环境对儿童神经心理发育水平的影响,为门诊家庭养育指导提供科学依据。方法 选取2021年9月—2022年6月在嵊州市妇幼保健院儿童生长发育门诊体检的631名0~3岁婴幼儿进行发育筛查,对家庭主要养育人进行家庭养育环境调查,调查结果进行单因素和多因素分析。结果 631名儿童发育商(DQ)可疑异常率为15.53%,>1~3岁儿童发育商可疑和异常率高于0~1岁儿童,差异有统计学意义(χ²=4.21,P=0.040)。0~1岁组与>1~3岁组出生体重低(χ²=26.739、6.831)、多胎次(χ²=74.047、21.840)、孕周小(χ²=12.495、11.883)、主要抚养人学历低(χ²=29.968、11.498)的儿童发育商较低(P＜0.01)。“经常/总是把孩子捆扎得很紧孩子四肢手足难以活动”是0~1岁儿童发育可疑异常的危险因素(OR=5.283,95%CI:1.317~21.185),“经常/总是训练孩子手的操控能力”有助于提高0~1岁儿童的发育商(OR=0.347,95%CI:0.131~0.916),“养育者经常/总是让孩子自己尝试穿衣做事”(OR=0.475,95%CI:0.251~0.898)有助于提高>1~3岁儿童的发育商(P＜0.05)。结论 嵊州市>1~3岁儿童发育可疑和异常率较高,门诊应重点关注出生体重低、多胎次、孕周小、主要抚养人学历低的儿童,可应用家庭养育环境量表提示的相应内容对家庭养育人进行家庭养育指导。

Abstract

Objective To understand the impact of the family nurturing environment on the neuropsychological development level of children, so as to provide a scientific basis for family nurturing guidance in outpatient clinics. Methods From September 2021 to June 2022, developmental screening was conducted on 631 children aged 0 - 3 years at the Child Growth and Development Clinic of Shengzhou Maternal and Child Health Hospital, along with a survey on the family nurturing environment of their primary caregivers. The survey results were analyzed using univariate and multivariate methods. Results The suspected abnormality rate of the developmental quotient (DQ) among the 631 children was 15.53%. The rate of suspected and abnormal DQ was significantly higher in children aged >1 - 3 years compared to those aged 0 - 1 year (χ²=4.21, P=0.040). In both the 0 - 1 year and >1 - 3 year groups, children with low birth weight (χ²=26.739, 6.831), higher birth order (χ²=74.047, 21.840), smaller gestational age (χ²=12.495, 11.883), and lower educational level of the primary caregiver (χ²=29.968, 11.498) had significantly lower DQ scores (P<0.01). "Often/Always swaddling the child tightly, restricting limb movement" was a risk factor for suspected developmental abnormalities in children aged 0 - 1 year (OR=5.283, 95%CI: 1.317 - 21.185). "Often/Always training the child's hand manipulation skills" was associated with higher DQ in children aged 0 - 1 year (OR=0.347, 95%CI: 0.131 - 0.916). "Often/Always allowing the child to try dressing and doing things independently" was associated with higher DQ in children aged >1 - 3 years (OR=0.475, 95%CI: 0.251 - 0.898) (P<0.05). Conclusions The suspected and abnormal DQ rates are relatively high among children aged >1 - 3 years in Shengzhou. Outpatient clinics should focus on children with low birth weight, higher birth order, smaller gestational age, and lower educational levels of primary caregivers. Guidance for family caregivers can be provided using the relevant content indicated by the family nurturing environment scale.

关键词

发育商 / 养育环境 / 神经心理发育 / 儿童

Key words

developmental quotient / nurturing environment / neuropsychological development / children

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基金资助

嵊州市级科技计划项目(C23L85C1320);绍兴市基础公益类计划项目(2023A14034);浙江省疾病预防控制局(2025JK118)