前囟闭合早晚与学龄前儿童身高发育轨迹的关联研究  

Association between the anterior fontanelle closure time and height growth trajectory in preschool children

作　　者：梅红[1] 蔡晓楠 夏治国 陈艳[2] 肖晗 MEI Hong;CAI Xiao-nan;XIA Zhi-guo;CHEN Yan;XIAO Han(Institute of Maternal and Child health,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei,Wuhan 430016,China;不详)

机构地区：[1]华中科技大学附属武汉儿童医院妇女儿童健康研究所,湖北武汉430016 [2]华中科技大学附属武汉儿童医院儿童保健科

出　　处：《现代预防医学》2021年第19期3509-3514,3523,共7页Modern Preventive Medicine

基　　金：国家自然科学基金青年基金(81903332)。

摘　　要：目的分析前囟闭合时间对学龄前儿童身高发育轨迹的影响。方法采用回顾性队列研究方法,以140710例学龄前儿童为研究对象。利用组基轨迹模型对研究对象2~6岁间身高发育轨迹进行拟合,并分为快速增长组(FG)、正常增长组(NG)和缓慢增长组(SG)。利用方差分析或卡方检验对多组连续变量或分类变量进行描述性分析,采用非条件logistic回归分析前囟闭合时间与身高发育轨迹分组间的关联性。结果FG、NG和SG三组儿童的频数和百分比分别为34722(24.68%)、81904(58.21%)和24084(17.11%)。与NG组和SG组相比,FG组12月龄前囟闭合率更高。男童1岁前囟门闭合的比例较女童更高,至18月龄时男女童的前囟闭合比例趋于一致。非条件logistic回归分析发现,以18月龄前囟闭合的对象为对照,与NG组相比,前囟在18月龄前闭合的儿童FG组可能性更高,如前囟12月龄闭合时FG组校正OR(95%CI)为1.15(1.11~1.20);而前囟在18月龄后闭合的儿童SG组的可能性更高,如24月龄闭合时SG组校正OR(95%CI)分别1.16(1.12~1.20)。结论与18月龄前囟闭合的儿童身高发育相比,前囟闭合较早的儿童学龄前期身高发育较快的可能性更大,前囟闭合较晚的儿童学龄前期身高发育较慢的可能性更大。Objective To analyze the effects of anterior fontanelle closure time on children’s height growth.Methods Retrospective cohort study was used with 140710 preschool children involved as the subjects.The group-based trajectory modeling was adopted to generate the height growth trajectories,which was divided into three groups,namelythe fast growth group(FG),normal growth group(NG)and slow growth group(SG).The descriptive analysis of continuous and category variables was made by ANOVA and chi-square test.Unconditional logistic regression analysis was used to evaluate the association between the closure time of anterior fontanelle and height growth trajectory groups.Results There were 34722(24.68%),81904(58.21%)and 24084(17.11%)children in the FG,NG and SG groups respectively.Compared to the NG and SG groups,participants in the FG group had a higher anterior fontanelle closure rate at 12 months of age.Compared to girls,boys had a higher anterior fontanelle closure rate at 12 months old,while they had similar anterior fontanelle closure rate after 18 months old.The unconditional logistic regression analysis showed that as these with anterior fontanelle closing at 18 months old as comparison,the FG group had a higher probability of anterior fontanelle closed before 18 months old,for example fontanelle closed at 12 months old,the adjusted OR and 95%CI of FG group was 1.15(1.11-1.20);while the NG group had a higher probability of anterior fontanelle closed after 18 months old,for instance,the adjusted OR and 95%CI of fontanelle closed at 24 months old was 1.16(1.12-1.20).Conclusion Compared with anterior fontanelle closed at 18 months old,the earlier the anterior fontanelle closure time,the higher probability of growing higher during preschool age.The later the anterior fontanelle closure time,the higher probability of growing lower during preschool age.

关 键 词：囟门 学龄前儿童 身高发育 

分 类 号：R179[医药卫生—妇幼卫生保健]