徐州市学龄前儿童发育性协调障碍现况及影响因素分析

Current status and influencing factors of developmental coordination disorder among preschool children in Xuzhou

摘要

目的 了解徐州市学龄前儿童发育性协调障碍(DCD)的现况及影响因素,为DCD的早期预防、诊断及干预提供理论依据。方法 采用横断面研究,于2023年3—4月使用中文版小龄发育性协调障碍问卷(Little DCDQ) 对徐州市611所幼儿园117 479名学龄前儿童进行运动协调能力筛查。根据问卷总分将儿童分为正常组、疑似组和阳性组,采用χ²检验比较不同特征儿童DCD筛查结果的差异,采用无序多分类logistic回归分析DCD疑似和筛查异常的相关因素。结果 徐州市学龄前儿童DCD筛查阳性率为12.0%,筛查可疑率为10.9%。而阳性组、疑似组、正常组儿童在性别、年龄、分娩方式、早产、出生时缺氧窒息、母亲孕期吸烟、父亲文化程度、母亲文化程度、6月龄前喂养方式、每日视屏时间、每日户外活动时间、每日中高强度体力活动时间等方面差异有统计学意义(χ²=27.39～2 274.06,P＜0.001)。多因素logistic回归分析结果显示,男童、阴道助产、早产、出生时缺氧窒息、每日视屏时间＞2h、每日户外活动时间＜2h、每日中高强度体力活动＜1h、6月龄前混合喂养和人工喂养、父母亲文化程度低与DCD筛查疑似和阳性呈正相关(P＜0.05),母亲孕期吸烟与DCD筛查阳性呈正相关(P＜0.05); 儿童年龄较大与DCD筛查疑似和阳性呈负相关(P＜0.05)。结论 徐州市学龄前儿童DCD筛查阳性及疑似检出率较高,与儿童性别、年龄、生活习惯、出生时情况及带养人文化水平等多种因素有关,建议医教结合针对相关影响因素实施早期预防和干预。

Abstract

Objective To investigate the detection rates of developmental coordination disorder (DCD) among preschool children in Xuzhou, and to identify influencing factors, so as to provide a theoretical basis for its early prevention, diagnosis, and intervention. Methods A cross-sectional study was conducted between March and April 2023. The Chinese version of the Little Developmental Coordination Disorder Questionnaire (Little DCDQ) was used to evaluate the motor coordination abilities of 117 479 preschool children from 611 kindergartens in Xuzhou. According to the total little DCDQ score, children were classified into the normal, suspected, and positive DCD screening groups. χ² test was used to compare differences in DCD screening results among children with different characteristics, and multinomial logistic regression was performed to identify factors associated with suspected and abnormal DCD screening results. Results The screening positivity rate of DCD and suspected rate DCD among preschool children in Xuzhou were 12.0% and 10.9%, respectively. Significant differences were observed among the normal, suspected DCD, and DCD groups in children′s gender, age, mode of delivery, preterm birth, hypoxic asphyxia at birth, maternal smoking during pregnancy, paternal education level, maternal education level, feeding pattern before 6 months of age, daily screen time, daily outdoor activity time, and daily moderate-to-vigorous physical activity time (χ²=27.39 - 2 274.06, P<0.001). Multinomial logistic regression analysis showed that boys, assisted vaginal delivery, preterm birth, hypoxic asphyxia at birth, screen time >2 h/d, outdoor activity time <2 h/d, moderate-to-vigorous physical activity time <1 h/d, mixed or formula feeding before 6 months of age, and lower parental education levels were positively associated with suspected and abnormal DCD screening results(P<0.05). Maternal smoking during pregnancy was positively associated with positive DCD screening results (P<0.05). Older age was negatively associated with lower odds of suspected and positive DCD screening results (P<0.05). Conclusions The detection rates of positive and suspected DCD screening results among preschool children in Xuzhou are relatively high, which is associated with children′s gender, age, lifestyle factors, perinatal factors, and parental education level. Integrated medical and educational efforts are recommended to support early prevention and intervention strategies targeting relevant associated factors.

关键词

发育性协调障碍 / 筛查 / 运动协调能力 / 学龄前儿童

Key words

developmental coordination disorder / screening / motor coordination ability / preschool children

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基金资助

徐州市卫生健康委医学科技创新面上项目(XWKYHT20230085);徐州市卫生健康委医学科技创新青年项目(XWKYHT20230052);徐州市妇幼保健院院级课题(XFBYKTF202408)