合肥市6月龄婴儿喂养困难状况及其与神经行为发育的关联研究  

Prevalence of feeding difficulties and early neurodevelopment for infants aged 6 months,Hefei

作　　者：王月 王鹏 周美婷 焦雪纯 李培 朱鹏[1,3,4] WANG Yue;WANG Peng;ZHOU Mei-ting;JIAO Xue-chun;LI Pei;ZHU Peng(Department of Maternal,Child and Adolescent Health,School of Public Health,Anhui Medical University,Hefei,Anhui 230032,China)

机构地区：[1]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系,合肥230032 [2]安徽省妇女儿童保健中心 [3]出生人口健康教育部重点实验室 [4]人口健康与优生安徽省重点实验室

出　　处：《现代预防医学》2022年第1期68-71,102,共5页Modern Preventive Medicine

基　　金：国家自然科学基金(81872631,81472991);安徽省高校优秀青年人才基金重点项目(gxyqZD2018025);安徽省学术和科技带头人后备人选科研资助项目(2017H141)。

摘　　要：目的了解合肥市婴儿喂养困难的发生及分布特征,探讨婴儿喂养情况与神经行为发育的关联。方法2016—2018年在合肥市区级妇幼保健服务中心共纳入1852名6~12月龄婴儿为研究对象,采用合肥市母婴健康调查问卷对婴儿家长进行调查,6月龄婴儿喂养困难评价是基于父母喂养问卷(Parental feeding questionnaire),采用年龄与发育进程问卷第3版(ASQ-3)评估12月龄婴儿发育状况,并采用单因素分析和多因素logistic回归分析婴儿喂养困难与其心理行为发育的关联。结果本研究中6月龄婴儿喂养困难发生率为18.5%。早产和低出生体重的婴儿喂养困难的发生率更高(早产VS非早产:68.4%VS 18.0%;低出生体重VS非低出生体重:38.6%VS 18.0%,P<0.05)。与无喂养困难的婴儿相比,有喂养困难婴儿的粗大运动、精细动作和个人-社会能区的低下和低常率更高(低常率分别为:19.8%,12.7%和12.6%,P<0.05);用餐时行为和食物拒绝和争夺控制权异常的婴儿其12月龄时的粗大运动和个人-社会的异常率更高。在调整混杂因素后,与非喂养困难婴儿相比,婴儿喂养困难与12月龄粗大运动(OR=1.64,95%CI:1.05~2.57),精细运动(OR=1.65,95%CI:1.10~2.49)和个人-社会能区(OR=1.52,95%CI:1.01~2.30)异常风险增加有关。结论6月龄婴儿喂养困难可能会增加12月龄心理行为发育障碍风险,为早期婴儿喂养状况干预提供证据。Objective To investigate the prevalence and risk factors of feeding difficulties,and to estimate the association of feeding difficulties with later neurodevelopment in infants aged 6 months in Hefei.Methods From 2016 to 2018,a total of 1852 infants were included in the study at maternal and child health service centers in Hefei City.Parental feeding questionnaires and Ages and Stages Questionnaires Edition 3(ASQ-3)were used for the assessment of feeding difficulties in infants aged 6 months and neurodevelopment in infants aged 12 months,respectively.Univariate analysis and multiple logistic regression model were used to estimate the relationship between infants’feeding difficulties and neurodevelopmental outcomes in infants.Results In this study,the prevalence of feeding difficulties was 18.5%.Infants with preterm birth or low birth weight had higher rates of feeding difficulties(preterm birth VS not preterm birth:68.4%VS 18.0%;low birth weight VS not low birth weight:38.6%VS 18.0%,P<0.05).Compared with the infants without feeding difficulties,those with feeding difficulties were inclined to the severe and mild developmental delays during 12 months in gross motor,fine motor and personal social domain(the rates of 3 domains with mild developmental delay:19.8%,12.7%and 12.6%,P<0.05,respectively).Moreover,similar results were also demonstrated in the infants with the behavior food refusal and struggle for control feeding at meals.After adjusting a set of confounders,feeding difficulties were associated with higher risks of failing the gross motor[OR with95%CI:1.64(1.05-2.57)],fine motor[1.65(1.10-2.49)]and personal social domain[1.52(1.01-2.30)]in infants aged 12 months.Conclusion Infants with feeding difficulties aged 6 months have higher risks of neurodevelopmental delays in 12 months,providing evidence on the intervention of infancy feeding disturbances.

关 键 词：喂养困难 神经发育 低出生体重 早产 

分 类 号：K174[历史地理—历史学]