轻度早产儿语言发育落后的多因素分析  

Multivariate analysis of language development retardation in mild preterm infants

作　　者：徐小晶 倪钰飞[1] 张雪玉 王飞英[1] 许占斌 江琤琤 XU Xiaojing;NI Yufei;ZHANG Xueyu;WANG Feiying;XU Zhanbin;JIANG Chengcheng(Department of Child Health,Maternal and Child Health Hospital Affiliated to Nantong University,Jiangsu Nantong 226000,China;Nantong Chongchuan District Health Committee,Jiangsu Nantong 226000,China)

机构地区：[1]南通大学附属妇幼保健院儿童保健科,江苏南通226000 [2]南通市崇川区卫生健康委员会,江苏南通226000

出　　处：《中国妇幼健康研究》2021年第9期1282-1286,共5页Chinese Journal of Woman and Child Health Research

基　　金：南通市妇幼健康专科联盟科研项目(TFM201908);2018年江苏省卫健委科研项目(Y2018041)。

摘　　要：目的该研究从依恋类型、气质、抚养人及带养环境等方面比较轻度早产儿和足月儿的语言发育情况。方法于2017年11月至2019年1月收集在南通市妇幼保健院儿童保健科高危儿门诊体检的轻度早产儿87例作为观察组,另外选取同期出生的正常足月儿100例作为对照组。18月龄时采用问卷调查、气质量表、陌生场景测试等方法对两组儿童进行评估并比较分析。结果观察组的语言表达能力、听觉感受和理解能力,以及视觉理解和表达能力的发育得分均低于对照组(t值分别为22.01、18.23、8.38,P<0.05)。母亲教育水平(OR=0.623)、母亲焦虑程度(OR=0.754)、儿童的依恋类型(OR=1.378)、气质类型(OR=1.143)与儿童的语言发育显著相关。观察组非安全依恋型及难养/缓慢型儿童语言发育异常率明显高于同类型的对照组儿童(χ^(2)值分别为7.117、4.867,P<0.05),观察组母亲焦虑的儿童语言发育异常率高于对照组,差异有统计学意义(χ^(2)=6.212,P<0.05)。结论轻度早产儿在矫正月龄18个月时,体格生长发育与足月儿无显著差异,但语言发育仍处于落后状态。母亲教育水平、焦虑程度、幼儿难养/迟缓型气质及不安全型依恋是轻度早产儿发生语言发育迟缓的危险因素。Objective This study compared the language development of mild preterm infants and full-term infants from the aspects of attachment type,temperament,caregiver and raising environment.Methods A total of 87 cases of mild preterm infants examined in the outpatient department of high-risk children of the child health department of Nantong maternal and child health hospital from November 2017 to January 2019 were selected as the observation group,and 100 cases of normal term infants born during the same period were selected as the control group.At the age of 18 months,the two groups of children were evaluated and compared by questionnaire,gas quality scale and unfamiliar scene test.Results The development scores of language expression ability,auditory perception and comprehension ability,visual comprehension and expression ability in the observation group were lower than those in the control group(t=22.01,18.23 and 8.38,respectively,P<0.05).Mother′s education level(OR=0.623),mother′s anxiety level(OR=0.754),children′s attachment type(OR=1.378)and temperament type(OR=1.143)were significantly related to children′s language development.The rates of abnormal language development of unsafe attachment type and difficult/slow type children in the observation group were significantly higher than those of the same type children in the control group(χ^(2)=7.117 and 4.867,respectively,P<0.05).The incidence of abnormal language development in children with anxious mothers in the observation group was higher than that in the control group,and the difference was statistically significant(χ^(2)=6.212,P<0.05).Conclusion There is no significant difference in physical growth and development between the mild preterm infants and term infants at corrected age of 18 months,but language development was still backward.Mother′s education level,mothers′anxiety,children′s difficult/slow temperament and unsafe attachment are the risk factors of language retardation in mild preterm infants.

关 键 词：轻度早产儿 语言发育异常 依恋方式 儿童气质 

分 类 号：R179[医药卫生—妇幼卫生保健]