农村3岁以下儿童心理行为发育问题预警征象筛查发育偏异及影响因素  

Prevalence and determinants of suspect developmental delay in Warning Sign for Children Mental and Behavioral Development screening among children under 3 years old in rural China

作　　者：周穗赞 张敬旭 王晓莉[1] ZHOU Sui-zan;ZHANG Jing-xu;WANG Xiao-li(Department of Maternal and Child Health,School of Public Health,Peking University,Beijing 100191,China)

机构地区：[1]北京大学公共卫生学院妇幼卫生学系,北京100191

出　　处：《中国儿童保健杂志》2020年第9期967-970,共4页Chinese Journal of Child Health Care

基　　金：联合国儿童基金会“儿童早期综合发展”项目(0860-A0-05-501-002)。

摘　　要：目的探查农村3岁以下儿童心理行为发育现况及影响因素,了解潜在转诊和干预需求,为制定相关防治策略提供证据支持。方法本研究采用以社区为基础的横断面调查设计,2016年7-9月在贵州和山西各1个贫困县中以村为单位整群抽样,样本村中所有3岁以下且满3月龄儿童为研究对象,采用相适应年龄组的儿童心理行为发育问题预警征象(预警征)分别进行发育筛查。χ2检验和Logistic回归分别用于发育偏异发生的单因素和多因素分析。结果本研究共纳入1298名儿童,其中89例(6.9%)早产儿,341例(26.3%)家庭贫困,559例(43.1%)留守儿童。调查儿童中有126例(9.7%)预警征筛查阳性,即发育偏异。但其中大部分偏异程度较轻,71.4%发育偏异儿童只出现4项中的1项预警征象异常。单因素和多因素分析均表明,早产儿发育偏异风险高于非早产儿(校正OR=2.193,95%CI:1.225~3.927),而且发育偏异发生与预警征问卷年龄组内细微月龄差距有关,组内月龄增大,发育偏异风险降低(校正OR=0.823,95%CI:0.701~0.967)。结论儿童心理行为发育问题预警征象筛查可以在农村地区3岁以下儿童健康体检时发现发育偏异。发育偏异的发生与早产有关,且对同一预警征问卷组内月龄差异敏感。Objective To analyze prevalence and determinants of suspect developmental delay(SDD)in Warning Sign for Children Mental and Behavioral Development(WSC-MBD)checklist screening among children under 3years old in rural China,so as to provide evidence for resource allocation for referral and intervention services,as well as the prevention strategy development.Methods A community based cross-sectional study was conducted from July to September 2016in two poverty counties in Guizhou and Shanxi provinces separately.Cluster sampling by village was used to select children aged<3years old and≥3months old.Age appropriate WSC-MBD was used by face-to-face interview with caregivers of children to detect SDD.Chi-square test and Logistic regression were used to examine the determinants of SDD.Results Total 1298children were enrolled,of whom 89(6.9%)children were preterm infants,341(26.3%)children with per capita net income of family less than 2300RMB/year,and 559(43.1%)were left-behind.Among all children,126(9.7%)children were detected with SDD,although 71.4%of SDDs were mild with only one abnormal warning sign out of 4signs in total.Both the univariate and multivariate analysis suggested preterm birth was associated with higher risk of SDD(adjusted OR=2.193,95%CI:1.225-3.927).The prevalence of SDD deceased along with the increase of month age within the same WSC-MBD group(adjusted OR=0.823,95%CI:0.701-0.967).Conclusions WSC-MBD is feasible to detect SDD among children in rural China.The risk of SDD is associated with preterm birth,and sensitive to the small month age difference within the same WSC-MBD group.

关 键 词：预警征 农村 儿童早期发展 发育筛查 

分 类 号：R174[医药卫生—妇幼卫生保健]