不同分娩方式对婴幼儿生长发育的影响  

Influence of delivery mode on cognition and body development of infants

作　　者：李素月 宋沅瑾 董建荣 赵胜侠 章依文[2] 姜艳蕊[2] 徐小娟[2] 孙莞绮[2] 王燕[2] 江帆[2] 

机构地区：[1]河北省石家庄市妇幼保健院,河北石家庄050051 [2]上海交通大学附属上海儿童医学中心教育部环境与儿童健康重点实验室,上海200092

出　　处：《中国妇幼健康研究》2014年第6期922-924,共3页Chinese Journal of Woman and Child Health Research

基　　金：国家自然科学基金资助项目(81172685);卫生部行业科研专项基金资助项目(201002006);上海市公共卫生重点学科资助项目;上海市科委基金资助项目(12411950405;13QH1401800);上海市教委曙光计划(11SG19)基金资助项目;圣元集团科研基金资助项目

摘　　要：目的探究不同分娩方式对婴幼儿生长发育的影响。方法于2012年11月至2013年3月,在河北省石家庄市城乡随机抽取142名儿童,由专人负责进行问卷调查了解婴幼儿分娩方式以及社会家庭环境状况,同时用贝莉发育评估量表(Bayley)Ⅰ对婴幼儿的认知发育情况进行评估。测量婴儿身长体重以计算身体质量指数(BMI)和身体质量指数Z评分(BMI-Z)值。结果被调查儿童平均月龄为11.63±8.46(2~30个月),其中男生占53.5%。智能发育指数(MDI)为106.83±15.12分,运动发育指数(PDI)为105.42±15.51分,BMI为17.17±2.26kg/m^2。单因素分析结果表明,剖宫产对儿童的MDI(t=0.724,P=0.471),BMI(t=-0.042,P=0.967)及BMI-Z(t=-0.219,P=0.827)均无影响,剖宫产儿童的PDI低于经阴道分娩的儿童(t=3.219,P=0.002)。在校正了年龄、性别、BMI、父母受教育程度及出生体重等后,多元线性回归分析的结果表明剖宫产仍与PDI显著相关(β=-0.292,P<0.001)。结论剖宫产对儿童PDI有显著影响,早期监测和干预可能有助于改善剖宫产儿童的运动发育。Objective To investigate the influence of delivery mode on cognition and body development of infants .Methods Totally 142 infants were randomly selected from urban and rural areas in Shijiazhuang from November 2012 to March 2013.The delivery mode and social family environment were surveyed with questionnaires by special experts .The Bayley Scales of Infant Development I were conducted on each participated infants .Height and weight were assessed to calculate BMI and BMI-Z value.Results The average age of the surveyed infants was 11.63 ＆#177;8.46 months （aged 2-30 months）, of which 53.5% were boys.The Mental Development Index （MDI） score and Psychomotor Developmental Index （PDI） score were 106.83 ±15.12 and 105.42 ±15.51, respectively, and BMI was 17.17 ±2.26kg/m2. Single factor analysis indicated that cesarean section had no influence on MDI （t=0.724, P=0.471）, BMI （t=-0.042,P=0.967） and BMI-Z （t=-0.219,P=0.827）.But the PDI of infants born with cesarean section was lower than that of infants born by vaginal delivery （t=3.219,P=0.002）.After adjusting confounding factors including age , gender, BMI, parents’ educational degree and birth weight, cesarean section was still significantly associated with PDI shown by multiple linear regression analysis （β=-0.292,P〈0.001）. Conclusion Cesarean section has strong influence on infant ’ s PDI.Early monitor and intervention may improve the motor development of infants born by cesarean section .

关 键 词：婴幼儿 分娩方式 认知发育 体格发育 

分 类 号：R179[医药卫生—妇幼卫生保健]