12月龄婴儿睡眠模式与6岁儿童行为问题的关联性研究  

Association between sleep patterns at 12 months of age and behavioral problems at 6 years of age in children

作　　者：袁姗姗 张丽芳 魏雪灵 产凡凡 王成锐 何健荣 邱琇 YUAN Shanshan;ZHANG Lifang;WEI Xueling;CHAN Fanfan;WANG Chengrui;HE Jianrong;QIU Xiu(Division of Birth Cohort Study,Guangzhou Women and Children's Medical Center,Guangzhou Medical University,Guangdong Guangzhou 510623,China;Department of Women's Health,Guangdong Provincial Key Clinical Specialtyof Woman and Child Health,Guangzhou Women and Children's Medical Center,Guangzhou Medical University,Guangdong Guangzhou 510623,China;Guangdong Provincial Clinical Research Center for Child Health,Guangzhou Women and Children's Medical Center,Guangzhou Medical University,Guangdong Guangzhou 510623,China;Provincial Key Laboratory of Research in Structure Birth Defect Disease,Guangzhou Women and Children’s Medical Center,Guangzhou Medical University,Guangdong Guangzhou 510623,China)

机构地区：[1]广州医科大学附属妇女儿童医疗中心出生队列研究室,广东广州510623 [2]广州医科大学附属妇女儿童医疗中心妇女保健部、广东省高水平临床重点专科(妇幼保健),广东广州510623 [3]广东省儿童健康与疾病临床医学研究中心,广东广州510623 [4]广东省结构性出生缺陷重点实验室,广东广州510623

出　　处：《中国妇幼健康研究》2024年第5期1-7,共7页Chinese Journal of Woman and Child Health Research

基　　金：国家重点研发计划项目(2022YFC2702903);国家自然科学基金面上项目(82173525);广东省自然科学基金重点项目(2022B1515120080)。

摘　　要：目的 探讨12月龄婴儿睡眠模式与6岁儿童行为问题的关系。方法 基于2012年启动至今的广州出生队列研究,采用前瞻性队列研究设计,纳入2012年5月至2016年12月出生的婴儿,且定期面对面随访至6岁的儿童。通过简明婴幼儿睡眠问卷,收集12月龄婴儿的睡眠资料,在其6岁时采用《长处与困难问卷》(父母版)评估其行为问题。基于12月龄婴儿睡眠资料中夜间睡眠时长及夜间入睡时点变量,采用层次K-means聚类方法构建婴儿睡眠模式。采用二分类Logistic回归模型分析12月龄婴儿睡眠模式与6岁儿童行为问题发生风险的关系。结果 在纳入的1 480名儿童中,构建出“少睡-早睡”“少睡-晚睡”“中睡-晚睡”“多睡-早睡”4种婴儿睡眠模式,分别占37.97%(562/1 480)、21.76%(322/1 480)、23.31%(345/1 480)、16.96%(251/1 480)。在6岁儿童行为问题的6个维度中,困难行为发生率最高,占9.53%;品行问题发生率次之,占8.85%;情绪症状发生率再次之,占8.24%。多因素Logisitic回归分析显示,以“多睡-早睡”模式为参照,在校正父母亲学历、母亲孕期烟草暴露、母亲孕期焦虑和抑郁水平、母亲产后抑郁水平,以及儿童性别、基于胎龄与性别的出生体重Z评分、0~6月龄喂养方式、婴儿期二手烟暴露和过敏有关因素后,12月龄婴儿“中睡-晚睡”模式的6岁儿童同伴交往行为问题发生风险增加(OR=2.434,95%CI:1.198~4.943,P=0.014);12月龄婴儿“少睡-早睡”和“少睡-晚睡”模式与6岁儿童情绪症状、品行问题、多动/注意缺陷行为问题、同伴交往行为问题、亲社会行为问题、困难行为的发生风险均无统计学关联(P>0.05)。结论 12月龄婴儿“中睡-晚睡”模式可能是6岁儿童同伴交往行为问题发生的危险因素。纠正婴儿期不良睡眠模式可能是早期预防、早期干预儿童行为问题的新靶点。Objective To explore relationship between children's sleep patterns at age of 12 months and their behavioral problems at age of 6 years.Methods In this prospective cohort study based on The Born in Guangzhou Cohort Study(BIGCS)started in 2012,the children who were born between May 2012 and December 2016,and participated in the BIGCS and received regular face-to-face follow up to 6 years old were included.Brief Infant Sleep Questionnaire(BISQ)was used to collect the infants sleep information at their 12 months of age,and Strengths and Difficulties Questionnaire(parent version)(SDQ)was used to assess children's behavioral problems at their 6 years of age.According to such variables as nighttime sleep duration and time point of falling asleep at night in the sleep information of the infants at their 12 months of age,in Hierarchical K-means clustering method,an infant's sleep pattern was constructed.Binary Logistic regression model was used to analyze relationship between infant's sleep patterns at 12 months of age and risk of behavioral problems at 6 years of age in children.Results A total of 1480 children were included in this study.Four infant sleep patterns were constructed,including less-early sleep pattern(n=562,37.97%),less-late sleep pattern(n=322,21.76%),median-late sleep pattern(n=345,23.31%),and more-early sleep pattern(n=251,16.96%).Among 6 dimensions of children's behavioral problems,the incidence rate of difficult behavioral problems was the highest,accounting for 9.53%,the incidence rate of conduct problems was the second,accounting for 8.85%and the incidence rate of emotional symptoms was the third,accounting for 8.24%.Multi-factor Logistic regression shown that after adjusting for such factors as parental educational levels,maternal smoking exposure during pregnancy,maternal anxiety and depression levels during pregnancy,maternal postpartum depression level,and child's gender,birth weight Z scores based on gestational age and gender,feeding pattern at 0-6 months of age,secondhand smoke exposure in i

关 键 词：婴儿睡眠 睡眠模式 儿童行为 队列研究 

分 类 号：R174[医药卫生—妇幼卫生保健]