剖宫产与学龄前儿童感觉统合失调的前瞻性队列研究  

Association between cesarean section and sensory integration dysfunction in preschool children:a prospective cohort study

作　　者：赵艳君 陈倩 黄丽素[3] 刘含 张军[2] ZHAO Yan-Jun;CHEN Qian;HUANG Li-Su;LIU Han;ZHANG Jun(Department of Child Health Care,Children's Hospital of Shanghai/Children's Hospital of Shanghai Jiao Tong University,Shanghai 200062,China;不详)

机构地区：[1]上海市儿童医院/上海交通大学附属儿童医院儿童保健科,上海200062 [2]上海交通大学医学院附属新华医院环境与儿童健康教育部/上海市重点实验室,上海200092 [3]上海交通大学医学院附属新华医院儿童感染科,上海200092 [4]上海交通大学医学院附属国际和平妇幼保健院妇产科,上海200030

出　　处：《中国当代儿科杂志》2021年第8期773-778,共6页Chinese Journal of Contemporary Pediatrics

基　　金：国家自然科学基金青年项目(81703235);上海市“医苑新星”青年医学人才培养资助计划(沪卫计人事(2019)72号);上海市普陀区青年英才计划(2020334);上海市儿童医院优秀青年人才培养计划(2017YYQ02);上海市儿童医院临床研究培育面上项目(2020YLYM04)。

摘　　要：目的采用前瞻性队列研究,评价剖宫产与学龄前儿童感觉统合失调的关联。方法依托上海交通大学医学院附属新华医院和附属国际和平妇幼保健院2012年建立的多中心母婴队列,于2017年采用儿童感觉统合能力发展评定量表,从前庭平衡、触觉防御和本体觉3个维度评价392名学龄前儿童感觉统合功能。剖宫产出生为暴露因素,阴道分娩者作为对照组。采用多因素logistic回归分析评估剖宫产与感觉统合各维度失调的关联。结果学龄前儿童感觉统合失调率为21.9%(86/392),前庭平衡、触觉防御和本体觉失调率分别为5.9%(23/392)、5.4%(21/392)和15.1%(59/392)。调整母亲分娩年龄、母亲受教育程度及儿童出生情况等混杂因素后,剖宫产儿童发生本体觉失调的风险性显著增加(RR=4.16,95%CI:1.41~12.30,P<0.05)。按性别分层分析发现,剖宫产男童本体觉失调的发生风险高于阴道分娩男童(RR=5.75,95%CI:1.26~26.40,P<0.05)。结论剖宫产能显著增加学龄前儿童本体觉失调的发生风险,尤其是对男童的影响更为明显。Objective To study the association between cesarean section and sensory integration dysfunction(SID)in preschool children through a prospective cohort study.Methods Based on the multicenter mother-infant cohort established by the Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the International Peace Maternity and Child Health Hospital Affiliated to Shanghai Jiao Tong University School of Medicine in 2012,the sensory integration functions(three dimensions:vestibular balance,tactile defensiveness,and proprioception)of 392 preschool children were evaluated by the Chinese Children Sensory Integration Capacity Development Rating Scale in 2017.Births by cesarean section were the exposure factors,and the children born by vaginal delivery were enrolled as controls.A multivariable logistic regression analysis was used to evaluate the association of cesarean section with each dimension of SID.Results The prevalence rate of SID was 21.9%(86/392)among the preschool children,and the prevalence rates of vestibular balance disorder,tactile over-responsivity,and proprioceptive disorder were 5.9%(23/392),5.4%(21/392),and 15.1%(59/392)respectively.After adjustment for the confounding factors including maternal age at delivery and maternal educational level and child birth situation,the cesarean section group had a significant increase in the risk of proprioceptive disorder(RR=4.16,95%CI:1.41-12.30,P<0.05).The stratified analysis based on sex showed that the boys born by cesarean section had a significantly higher risk of proprioceptive disorder than those born by vaginal delivery(RR=5.75,95%CI:1.26-26.40,P<0.05).Conclusions Cesarean section can significantly increase the risk of proprioceptive disorder in preschool children,especially in boys.

关 键 词：感觉统合失调 剖宫产 队列研究 学龄前儿童 

分 类 号：R748[医药卫生—神经病学与精神病学]