学龄前儿童血红蛋白浓度与智力发育水平的相关性研究

目的 探讨学龄前儿童血红蛋白(Hb)浓度与智力发育水平之间的相关性.方法 研究对象为河北、江苏、浙江3省21个市县1993-1996年出生的7331名儿童.平均54月龄时测量Hb浓度;平均68月龄时使用中国-韦氏幼儿智力量表进行智力测试.分析Hb浓度与全量表智商、语言智商和操作智商得分之间的关系.结果 贫血组与非贫血组儿童的语言智商得分分别为91.6±18.0、92.3±17.5(P=0.144),操作智商得分分别为102.2±15.6、103.1±15.0(P=0.055),全量表智商得分分别为96.4±17.1、97.3±16.4(P=0.079).调整儿童性别、智力测量时月龄、地区、产次以及母亲智商、文化程度、职业等因素之后,贫血组儿童发生低语言智商、操作智商、全量表智商得分的风险是非贫血儿童的1.3倍(OR=1.3,95%CI:1.1～1.6)、1.3倍(OR=1.3,95%CI:1.1～1.5)和1.4倍(OR=1.4,95%CI:1.2～1.6).按照每20个百分位间隔将lib浓度分成5组分析,Hb浓度偏低组(Hb＜110 g/l)、中等浓度组(117 g/L≤Hb＜122 g/L)、偏高组(Hb≥130 g/L)儿童的语言智商得分分别为90.6±18.1、94.0±17.6、91.0±16.4;操作智商得分分别为102.2±15.7、104.6±14.8、100.5±14.9,全量表智商得分分别为95.9±17.3、99.0±16.4、95.2±15.6;Hb浓度偏低或偏高组儿童的智力得分均低于Hb水平中等组,差异有统计学意义(P＜0.001).调整混杂因素后,Hb浓度偏低组儿童发生语言智商、操作智商、全量表智商得分较低的风险是Hb浓度中等浓度组儿童的1.4倍(OR=1.4,95%CI:1.1～1.7)、1.4倍(OR=1.4,95%CI:1.1～1.8)和1.5倍(OR=1.5,95%CI:1.2～1.8).未见Hb浓度偏高组儿童发生低智商得分的风险高于Hb水平中等组.结论 儿童低Hb浓度可能对智力发育有不利影响.     

低出生体重与孕期血红蛋白浓度的关系

目的 分析低出生体重(LBW)与孕期不同阶段血红蛋白(Hb)浓度之间的关系.方法 比较江苏省和浙江省4个县市1995～2000年102 489例孕妇孕期各阶段贫血和非贫血LBw儿的发生率,以及不同Hb浓度LBW儿的发生率;用Logistic回归控制年龄、文化程度、孕次、妊娠高血压疾病的影响,分析孕期各阶段Hb与LBW的关联程度.结果 孕早期贫血LBW儿发生率高于非贫血,孕晚期贫血LBW儿发生率低于非贫血,差异有统计学意义(P＜0.001);孕早期Hb浓度与LBW的风险呈线性趋势,Hb浓度降低,LBW的风险增加;孕中期低Hb浓度的孕妇LBW儿的发生率较高,高Hb浓度孕妇LBW儿的风险没有明显增加或降低趋势;孕晚期Hb浓度与LBW的风险呈"U"形趋势,高Hb和低Hb浓度都与LBW的风险增加有关.结论 孕期Hb浓度与LBW的关系随孕期的不同阶段而不同;孕早期贫血、孕晚期Hb浓度过高或过低均与LBW的风险增加有关.     

妊娠晚期血红蛋白浓度与早产和低出生体重关系的研究

目的分析妊娠晚期血红蛋白(Hb)浓度与早产和低出生体重之间的关系。方法研究对象为江苏和浙江省4个县(市)在1995—2000年间分娩的102 489名妇女。按妊娠晚期Hb浓度分四组比较各组早产和低出生体重的发生率;采用logistic回归模型控制年龄、职业、文化程度、孕次、产检次数和妊高征等因素后,估计Hb与早产和低出生体重的关联程度。结果妊娠晚期贫血患病率为48.2%,以轻度和中度贫血为主。轻、中度贫血不增加早产和低出生体重的风险。当Hb为90～99 g/L时,早产和低出生体重的发生率最低;当Hb升高或降低时,早产和低出生体重的风险均呈增加趋势。Hb为70～119 g/L时,早产和低出生体重的风险变化不大,但重度贫血和高血红蛋白则显著增加早产和低出生体重的风险:Hb<70 g/L组早产和低出生体重的OR(95%CI)分别为1.8(1.0～3.3)和4.0(2.1～7.5);Hb≥130 g/L组的早产和低出生体重的OR(95%CI)为1.2(1.0～1.4)和1.5 (1.2～1.9)。结论妊娠晚期Hb水平与早产和低出生体重的风险之间均呈"U"形趋势,妊娠晚期重度贫血以及高血红蛋白均是早产和低出生体重的危险因素。     

2004年长沙市城区部分0～6岁儿童血红蛋白与血铅水平检测分析

[目的]了解长沙市城区部分0～6岁儿童血铅水平与血红蛋白(Hb)浓度的关系.[方法]2004年6月,在长沙市城区开福区、芙蓉区抽取1 172名0～6岁儿童,测定末梢血中血铅水平与Hb浓度.[结果]检测1 172人,检出铅中毒87例,检出率为7.42%;检出贫血19例,检出率为1.62%.儿童Hb浓度为(124.47±7.66) g/L,血铅水平为(59.17±30.08) μg /L,二者的相关系数(r)=-0.046(P＞0.05).Hb浓度(g/L)为＜110、110～、120～、130～、140～各组,Hb浓度与血铅水的r值分别为-0.400、-0.008、-0.076、-0.088、-0.153,只有120～129 g/L组的相关有统计学意义(P＜0.05),其他各组二者的相关均无统计学意义(P＞0.05).铅中毒儿童发生贫血的OR值为5.86,贫血儿童发生铅中毒的OR值为0.19.[结论]长沙市城区部分0～6岁儿童Hb浓度与血铅水平不存在相关关系;铅中毒者发生贫血的OR值为5.86,贫血者发生铅中毒的OR值为0.19.     

父母接触CS2与子女智能发育的关系

目的研究父母怀孕前接触不同浓度CS2对子女智商发育的影响.方法应用WlSC-R对父母孕前接触CS2＞2 a 的61名儿童和39名对照组儿童进行智商测定,并计算平衡年龄、文化因素后的智商得分(VIQ,PIQ,FIQ)和因子(A,B,C因子)得分.结果不同浓度接触组与对照组比较,经单因素方差分析,智商和因子得分差异均有显著意义,其中高浓度组得分最低.将接触组儿童分成父亲接触组、母亲孕前接触组,并与对照组进行比较,3组智商和因子得分差异有非常显著意义,父亲接触组得分最低.经Dunnett分析表明,父亲接触组与母亲接触组及对照组比较,差异有显著性.母亲接触组与对照组比较,差异无显著性.相关分析表明,母亲和父亲文化水平、孕前工龄、生育年龄、新生儿出生体重与儿童智商得分有相关关系.多元逐步回归分析表明,只有父母亲文化水平、父亲接触工龄等进入回归方程. 结论父亲高浓度接触CS2将导致子女智力发育水平低下,父亲接触CS2其子女智商得分低于母亲孕前接触组,接触组儿童智力发育与父亲接触工龄有关,也与父母文化水平有关.     

父母智商分项对独生与非独生子女智商的影响

目的研究父母智商分项对独生子女和非独生子女智商(Intelligenee quotient,IQ)的影响,以便更好地促进儿童智力发育.方法随机抽取合肥市4～14岁中等收入家庭的健康儿童81名及其父母作为研究对象,用韦氏智力量表评定儿童和其父母的智商,再分别将独生子女和非独生子女的全量表智商(FIQ)、言语智商(VIQ)和操作智商(PIQ)同其父母的智商分项进行多元逐步回归分析.结果独生子女的智商和母亲算术、积木图案及父亲填图成正相关;非独生子女的智商和父母亲知识、拼物及父亲算术成正相关.独生子女的言语智商和母亲算术、父亲填图成正相关;非独生子女的言语智商和母亲知识、父亲算术及父母亲拼物成正相关.独生子女的操作智商和母亲积木图案、算术及背数成正相关;非独生子女的操作智商和母亲积木图案、父亲知识、背数、算术及拼物成正相关.结论母亲智商不仅在遗传方面,而且在儿童后天培养中对儿童智商起关键作用;父亲智商主要在儿童后天培养中对儿童智商起作用.     

壮族孕妇血红蛋白浓度和低出生体重关联强度剂量反应关系

目的 探讨孕期血红蛋白(Hb)浓度和低出生体重儿（LBW）的剂量-反应关系。方法 选取广西武鸣、平果、靖西、德保、隆安、田东等县级医院2015年1月 - 2017年12月入院的12 468例壮族孕妇作为研究对象,回顾性收集研究对象的一般人口学资料、孕期产检以及出生结局资料,采用非条件logistic回归分析孕期贫血、Hb变化对LBW的影响,限制性立方样条模型分析不同孕期Hb浓度、Hb变化和LBW的剂量-反应关系。结果 调整混杂因素后,非条件logistic回归显示,孕早期贫血组发生LBW的风险是非贫血组的1.69倍(aOR = 1.69,95%CI:1.38～2.07,P＜0.001);孕期Hb变化最低组发生LBW的风险是中值组的1.67倍(aOR = 1.67,95%CI:1.12～2.48,P = 0.012)。限制性立方样条显示,孕早期Hb浓度与LBW呈非线性 “L” 型剂量-反应关系(非线性检验:P＜0.001),孕晚期Hb浓度与LBW呈非线性 “U” 型剂量-反应关系(非线性检验:P＜0.001),孕期Hb变化与LBW倒 “L” 型剂量-反应关系(非线性检验:P＜0.001)。结论 孕早期贫血可增加LBW的发生风险,孕期Hb浓度及Hb变化与LBW呈非线性剂量-反应关系。     

婴儿期营养性缺铁性贫血与孕妇孕晚期贫血的相关性研究

目的了解婴儿营养性缺铁性贫血(IDA)的现状,研究孕妇孕晚期贫血与婴儿期IDA的关系,为预防婴儿早期IDA的发生提供科学依据。方法选取2014年4月-2016年3月在仪征市妇幼保健所儿保科门诊定期健康体检的5~8月龄婴儿,测定血常规。回顾性分析孕妇孕晚期贫血情况,比较孕妇孕晚期贫血、服用铁剂治疗、治愈与否对婴儿早期IDA的影响。结果婴儿血红蛋白(Hb)为(111.75±10.918)g/L,贫血发生率41.79%,轻度贫血占92.86%;孕妇孕晚期Hb≥110 g/L组与Hb110 g/L组婴儿Hb、孕妇贫血发生率分别为(112.73±10.759)g/L、38.75%和(107.91±10.750)g/L、53.66%(均P0.05);治疗组与未治疗组婴儿Hb、孕妇贫血发生率分别为(108.76±11.895)g/L、48.78%和(107.07±9.543)g/L、58.54%(均P0.05);治愈组与未治愈组婴儿Hb、贫血发生率分别为(114.88±9.951)g/L、19.05%和(104.86±9.672)g/L、80.00%(均P0.05)。结论 5~8月龄婴儿IDA发生率处于较高水平,而孕后期贫血是婴儿早期发生IDA的重要影响因素,因此采取切实可行的措施预防母亲孕后期贫血,是减少婴儿IDA发生的关键。     

儿童行为问题的典型相关研究

目的通过韦氏智商测试结果与儿童行为问题、精神运动功能测试结果的典型相关分析,找出二者的相关因素,从而为诊断和干预提供依据。方法在4所小学1～5年级学龄儿童中选择2 0 0 0名儿童为研究对象。采用Achenbach儿童行为问卷(CBCL)父母问卷和联合瑞文智力测验筛选行为问题 儿童进行分析。结果韦氏智商测试与因子异常的相关主要是韦氏全量表智商(FSIQ)与交往不良因子(V4 2 )之间的相关,韦氏智商测试与精神运动功能测试的相关主要是韦氏操作智商(PIQ)与数字连接t分(V17)之间的相关。结论韦氏全量表智商越低,儿童越有趋向于发生交往不良因子异常的可能。韦氏操作智商越低,儿童空间知觉和操作活动为主的智力水平就越低。     

发育性协调障碍儿童智力结构特点分析

目的研究发育性运动协调障碍儿童智力发育水平及特点,为早期干预提供方法和依据。方法在知情同意、自愿参加的原则下,在昆山市区随机抽取幼儿园儿童共1 867人,以美国精神病诊断手册第4版(DSM-Ⅳ)为诊断标准,确诊发育性协调障碍(developmental coordination disorder,DCD)者共112名,患病率为6.0%;其中59名儿童自愿参加智力测试,另随机选取同年龄同性别的正常儿童59例为对照组,均进行韦氏智力测试。结果 DCD组儿童的总智商得分、操作智商得分、动物房、图画补缺、迷津、几何图形、木块图案等项目得分均显著低于正常组儿童,差异有统计学意义(P均0.01);DCD组儿童与正常组儿童语言智商得分比较,差异无统计学意义。DCD组智力不平衡的比例显著高于对照组儿童,差异有统计学意义(P均0.01)。结论患有DCD学龄前儿童的操作智商低于正常儿童,但语言智商与正常儿童差异无统计学意义,在训练和教育中应有针对性的进行干预。     

Intellectual development of children born of mothers who fasted in Ramadan during pregnancy

The long-term effects of Ramadan fasting during pregnancy on the brain development of the fetus are still not clear. The aim of this study was to evaluate the effects of maternal fasting during Ramadan on the intelligence quotient of their progeny. A historical cohort study was conducted on 191 children aged between 4 to 13 years, 98 whose mothers fasted throughout Ramadan when they were pregnant with their children (case group) and 93 children whose mothers did not fast (control group). The children were selected from 15 schools via a questionnaire filled out by their mothers. Detailed demographic, medical history, and socioeconomic status data were collected by interviewing the mothers. All children aged between 6 to 13 were administered the Wechsler Intelligence Scale for Children-Revised (WISC-R), and those aged between 4 to 6 were administered Wechsler Preschool and Primary Scales of Intelligence (WPPSI), and intelligence quotient was estimated. Cases included 47 boys and 51 girls aged 8.5+/-2.5 years and controls included 44 boys and 49 girls aged 8.7+/-2.5 years. There were no significant differences in sex and age between two groups. Among background and confounder variables, the percentage of Caesarean section and the duration of breast-feeding were significantly different between case and control groups; 29% Caesarean section in cases vs. 45% in controls (p < 0.05) and 17.2+/-9 months breast-feeding for cases vs. 14.5+/-9 months for controls (p < 0.05). There were no significant differences in socioeconomic status of families between the groups whereas socioeconomic status accounted for approximately 17% of the variances in the average of full-scale intelligence quotient scores. Adjusted mean and standard deviation of full-scale intelligence quotient scores, performance and verbal, were 111+/-10, 109+/-11 and 110+/-11 for the case group and 112+/-10, 110+/-11 and 110+/-11 for the control group respectively. No significant differences were observed between the IQ scores of the two groups. Fasting during gestation did not adversely affect IQ of children whose mothers had fasted during Ramadan while being pregnant.     

Breast feeding and cognitive development in childhood: a prospective birth cohort study

The aim of this study was to examine prospectively the relation between duration of breast feeding and cognitive outcomes. A cohort study of 2860 children enrolled before birth provided data from 2393 term infants of English-speaking mothers. Of these, complete infant feeding data in the first year of life and verbal cognitive IQ (Peabody Picture Vocabulary Test - PPVT-R) were available for 1450 children at 6 years, and a performance subtest (Perceptual organisation WISC - Block Design) for 1375 children at 8 years. Full breast feeding was categorised as none,> 0 to < 4 months, 4-6 months and> 6 months. Associations between breast-feeding duration and PPVT-R at 6 years and Block Design at 8 years were estimated before and after adjustment for gender, gestational age, maternal age, maternal education, parental smoking and the presence of older siblings. The early cessation of full breast feeding was associated with reduced verbal IQ and the performance subtest. In unadjusted analysis, mean standardised PPVT-R scores were 6.44 points greater (P < 0.0001) in children fully breast fed for> 6 months compared with those never breast fed. After adjustment, mean PPVT-R scores were 3.56 points higher in children fully breast fed for> 6 months compared with those children never breast fed (P = 0.003). Similarly, Block Design scores were higher in those fully breast fed for> 6 months compared with those never breast fed in unadjusted (P = 0.001) but not adjusted analyses (P = 0.223). Interactions between maternal education (four levels) and breast feeding demonstrated a positive association of maternal education on verbal IQ (F = 2.64; P = 0.005) in children breast fed for longer but not on performance (F = 0.74; P = 0.67). The early introduction of milk other than breast milk was associated with reduced verbal IQ after adjustment for social and perinatal confounders. Although these effects were interacting with maternal education, they may act through undefined mechanisms in human milk.     

BDNF Val66Met多态性与儿童智力的关联性研究

目的研究脑神经营养因子(BDNF)Val66Met基因多态性与儿童智力的关系,为开展儿童智力的相关研究提供参考。方法以韦氏儿童智力量表(WISC-CR)测量115名6~16岁学龄儿童智商,采用聚合酶链反应-限制性片段长度多态性分析(PCR-RFLP)检测BD-NF Val66Met多态性,方差分析各基因型言语智商(VIQ),操作智商(PIQ)和总智商(FIQ)之间的关联。结果女童VIQ和FIQ与BDNF Val66Met基因型有显著性关联,Met纯合子者得分显著高于Val纯合子;男童BDNF Val66Met与智商的关联无统计学意义。结论BDNF Val66Met基因多态性可能影响女童VIQ和FIQ。     

卵胞浆内单精子注射子代4岁龄智能发育情况分析

目的 分析卵胞浆内单精子注射(ICSI)子代4岁龄智能发育情况。方法 选取2009年1月-2009年12月在南京市妇幼保健院进行卵胞浆内单精子注射的单胎活产子代作为研究对象(ICSI,n=18例),以年龄、性别为匹配条件,选取该院出生的自然受孕单胎活产婴儿为作对照组(SC,n=36例);排除标准:孕周<32周,体重<1 500g,有宫内窘迫,出生窒息史者。利用中国韦氏学前儿童智力量表(C-WPPSI)分别比较两组儿童4岁龄的智力发育水平。结果 比较两组儿童4岁龄智能发育水平后发现,韦氏智力测验中ICSI子代总智商、言语智商及操作智商均值在正常范围,但得分均低于SC组(总智商:ICSI 100.67±11.45,SC 115.33±10.82;言语智商:97.72±14.21,111.72±12.40;操作智商:104.83±7.87,116.50±10.68),两者差异具有统计学意义(P<0.05)。进一步分析两组智力异常的发生率,发现ICSI子代图画填充项目量表分<7的人数明显高于SC组(ICSI 4/18,SC 0/36,χ²=8.64,P<0.05)。结论 有限的样本量结果提示,ICSI子代4岁龄智能发育在正常范围,但韦氏智力测验IQ值低于SC组。ICSI子代远期智能情况需要通过更广泛、长期、系统的随访跟踪才能得出更为详实的结论。     

Exposure to arsenic and lead and neuropsychological development in Mexican children

This cross-sectional study examined the effects of chronic exposure to lead (Pb), arsenic (AS) and undernutrition on the neuropsychological development of children. Two populations chronically exposed to either high (41 children) or low (39 children) levels of As and Pb were analyzed using the Wechsler Intelligence Scale for Children, Revised Version, for México (WISC-RM). Geometric means of urinary arsenic (AsU) and lead in blood (PbB) were 62.9+/-0.03 (microgAs/g creatinine) and 8.9+/-0.03 (microg/dl) for the exposed group and 40.2+/-0.03 (microgAs/g creatinine) and 9.7+/-0.02 (microg/dl) for the reference group. The height for age index (HAI) was used as an indicator of chronic malnutrition and sociodemographic information was obtained with a questionnaire. Lead and arsenic were measured by atomic absorption spectrophotometry. Data on full, verbal, and performance intelligence quotients (IQ) scores, long-term memory, linguistic abstraction, attention span, and visuospatial organization were obtained through the WISC-RM. After controlling for significant potential confounders verbal IQ (P<0.01) decreased with increasing concentrations of AsU. The HAI correlated positively with full-scale and performance IQ (P<0.01). Higher levels of AsU were significantly related to poorer performance on WISC-RM factors examining long-term memory and linguistic abstraction, while lower scores in WISC-RM factors measuring attention were obtained at increasing values of PbB. Our results suggest that exposure to As and chronic malnutrition could have an influence on verbal abilities and long-term memory, while Pb exposure could affect the attention process even at low levels.     

衡阳市7—13岁儿童智力水平及影响因素

为进一步探讨儿童的智力发育水平及影响因素，本文采用中国—韦氏儿童智力量表（Ｃ—ＷＩＳＣ）对衡阳市２３８名小学生进行了智力测验和相关因素分析，结果表明，智商发育水平整体较高，呈正态分布，言语智商高于操作智商。智商与入学实足年龄、母亲受教育程度、学习成绩，课外活动爱好密切相关     

Body Size and Intelligence in 6-year-olds: Are Offspring of Teenage Mothers at Risk?

Objectives Children born to teenage mothers are at risk for more physical and cognitive problems than those born to adult mothers. Our objective was to examine differences in size and intelligence between two cohorts of offspring born to adolescent (n = 357) and adult mothers (n = 668) who attended the same prenatal clinic. Methods Two prospective study cohorts assessed children from gestation through age 6 years. The adult cohort was studied in the mid-1980’s and the teen cohort was evaluated in the mid-1990’s. Both samples were of low socio-economic status. The same study design and measures allowed us to adjust for the covariates of size and IQ. Results Offspring of adolescent mothers had a significantly smaller mean head circumference (5 mm) (HC) and higher body mass index (BMI) than offspring of adult mothers. Offspring of adolescent mothers scored significantly lower than the offspring of adult mothers on the Stanford-Binet (SBIS) composite score (4 points), and the quantitative (6.2 points), verbal reasoning (4.8 points), and short-term memory (3.9 points) area scores. Additional predictors of child IQ were maternal IQ, home environment, race, and number of siblings. When child HC was entered into our final regression model for the SBIS, maternal age and HC significantly predicted the composite score, the verbal reasoning, and short-term memory area scores. A 1 cm decrease in HC predicted a 1 point decrease in the SBIS composite score. Conclusions Compared to offspring of adult women, children of adolescent mothers have lower mean scores on cognitive measures, smaller head circumference, and higher BMI. These differences were significant after adjusting for differences between the two groups. Adolescent mothers and their children would benefit from interventions such as parenting support, education about nutritional needs, and advice on enriching the environments of their children.     

学龄前儿童智力水平和智力结构

目的:调查幼儿园大班全部儿童的智力水平,分析其智力结构,探讨认知能力发育规律,为学龄前儿童的学校教育和健康成长提供参考依据。方法:选择金坛市3家幼儿园大班全体儿童作为调查对象,共计345名儿童(男191人,女154人)参加此次调查,采用中国版韦克斯勒氏学龄前及初小儿童智力量表(WPPSI)一对一测定儿童智力。结果:所有儿童的平均智商为(101.80±11.88)。总智商在不同性别间无差异(P>0.05),男、女童的言语智商均小于操作智商(P<0.01)。有28.70%的儿童发生智商分离,其中,言语智商小于操作智商的占69.70%,智商分离与智商平衡者之间总智商的差异无统计学意义(P>0.05)。智力离散模型分析并无明显趋势,但言语分量表的离散值小于操作分量表的离散值(P=0.000)。结论:本组学龄前儿童言语智商小于操作智商,可能是:①儿童更多地接触相关材料选择性地提高了操作能力;②中国80年代修订的WPPSI需要修改以符合时代的发展;③儿童智力的离散模型值得进一步追踪研究。