农村30月龄幼儿行为发育及与智力和运动发展关系

目的探讨陕西农村30月龄幼儿的行为发育特点及其与智力及运动发展的关系。方法运用贝利婴幼儿发展量表对977名陕西农村30月龄幼儿的智力发育、运动发展以及行为表现进行测查,采用探索性因子分析行为发育特点,采用Spearman秩相关以及偏相关分析行为发育与智力及运动发展的关系。结果从各行为条目得分情况看,30月龄的幼儿正性情绪逐渐增加,如合作性(3.9±0.8)分、总的情绪(4.1±0.6)分、寻物的倾向性(3.9±0.7)分、持久性(4.1±0.5)分、观看兴趣(3.9±0.5)分,得分较高;负性情绪逐渐减少,如害怕(1.7±0.8)分、紧张(2.5±0.6)分、吮吸兴趣(1.1±0.5)分,得分较低;对25个行为条目进行探索性因子分析,共提取出6个公因子,分别为活动性、社会适应性、专注性、持久性、运动协调性以及亲和性,总方差贡献率为56.77%;各行为因子与智力发展的相关性均有统计学意义(均P0.05),调整后的相关系数绝对值为0.081~0.359;活动性、专注性、持久性以及运动协调性与运动发展的相关性有统计学意义(P0.05),调整后的相关系数绝对值为0.080~0.475。在所有的行为因子中,活动性与智力及运动发展的相关程度最高,调整后的相关系数分别为0.359、0.475。结论良好的行为表现与幼儿的智力、运动发育存在正性关联。对幼儿的异常行为进行合理干预和早期教育,促使其良好行为的形成,有助于提高其运动能力和认知能力。     

厦门市某制造企业工人营养知识、态度及行为现状调查

目的了解厦门市企业工人营养知识、态度及行为现状和影响因素,为开展营养健康教育提供依据。方法随机选取厦门市一家制造企业,采用问卷调查法对该企业全体工人进行营养知识(K)、态度(A)和行为(P)调查。结果该企业工人营养知识总知晓率为65.4%;营养知识、营养态度平均得分分别为9.16±2.69、24.31±2.85分;职工文化程度越高,得分越高(F=20.393,P0.05);营养知识得分越高,营养态度越积极(F=10.297,P0.01);营养知识得分越高,营养行为越合理(F=38.864,P0.05);营养态度得分越高,营养行为越合理(F=6.863,P0.05)。结论该企业员工营养知识不够健全,营养态度尚可,亟待开展营养健康教育。     

父辈童年期不良经历或影响幼儿端粒长度和行为问题

童年期不良经历与个体终身健康风险相关。生命历程理论认为,父辈童年期逆境经历导致的健康风险还可能代际传递至子代。美国杜兰大学医学院精神与行为科学系Kyle博士及团队对155名孕妇及分娩的婴儿开展了18个月随访,评价孕母童年期不良经历、产前应激和产后抑郁状况,并对婴儿在4,12,18月龄评估社会情绪与行为发育,收集口腔上皮细胞测量端粒长度,结果发现,孕母童年期不良经历得分髙可预测幼儿18月龄时外化行为问题和较短的端粒长度,且母亲童年期不良经历致外化行为问题可能与幼儿端粒衰减速度加快相关。     

母亲孕期焦虑情绪对儿童早期气质影响的研究

目的 探讨母亲孕期焦虑情绪对儿童早期气质的影响.方法 采用状态-特质焦虑量表对孕妇在孕32～34周时进行测试,采用中国4～8个月婴儿气质量表以及自制的婴儿基本情况调查表,对被调查的孕妇所生的婴儿在6个月时进行气质评定和基本情况调查.按照母亲孕期是否存在焦虑情绪及程度将婴儿分组,比较不同组别婴儿在气质类型和气质维度方面的差异.结果 母亲孕期有状态焦虑情绪组的婴儿中,麻烦型和发动缓慢型的比例偏高,且状态焦虑情绪程度越重比例越高(分别为:χ2=10.91,P<0.01;χ2=8.42,P<0.05);而无状态焦虑情绪组的婴儿中,平易型的比例偏高(χ2=7.31,P<0.05).母亲孕期特质焦虑情绪对婴儿气质类型的影响无显著性差异.母亲孕期状态焦虑情绪对婴儿气质因子中的节律性、趋避性、适应性、心境和持久性得分有影响(t=2.113～5.308,P<0.01或P<0.05);母亲孕期特质焦虑情绪对活动水平、心境和持久性等因子得分有影响(t=-2.339～3.001,P<0.01或P<0.05).结论 母亲孕期焦虑情绪对儿童早期的气质类型和气质维度可产生负面影响.     

孕期负性情绪与体重管理行为的相关性研究

目的 本研究旨在探究孕期负性情绪与孕期体重管理行为之间的关联性。方法 采用多阶段分层抽样的方法对江苏省常州市的孕妇开展横断面调查。通过问卷调查的方式收集社会人口学特征、抑郁、焦虑和孕期体重管理行为(运动管理、饮食管理和管理目标)的情况。应用多元线性回归分析探索负性情绪与孕期体重管理行为的相关关系。结果 在784名参与者中,孕期抑郁137(17.5%)例,孕期相关焦虑330(42.1%)例。单因素分析结果显示有无负性情绪两组间的体重管理量表得分有差异(P<0.05)。多因素线性回归分析结果显示负性情绪与运动管理行为(β=-1.108, P<0.01)、饮食管理行为(β=-0.737, P<0.01)和管理目标行为(β=-0.602, P<0.01)呈现负向相关。结论 妊娠期负性情绪对体重管理行为有负向影响。孕期体重管理的干预需要考虑孕妇的心理状态,对经历负性情绪的孕妇应当采取个性化的干预和治疗。     

厦门市某低技术制造企业职工营养知识、态度、行为调查及其影响因素

目的了解2013年度厦门市低技术制造企业工人营养知识、态度、行为现状和影响因素,为在厦门市低技术制造企业开展营养健康教育提供依据。方法对厦门某低技术制作企业工人438名进行营养知识(K)、态度(A)和行为(P)调查,了解其营养KAP现状并分析影响因素。结果 14个营养知识条目中,知晓率达到50%的有10个条目。该企业营养知识知晓率为61.8%。女性职工得分高于男性职工(F=16.823,P0.01);职工文化程度越高,得分越高(F=6.607,P0.01)。该企业营养态度中"吃不喜欢但有营养的食物"积极态度持有率仅为21.9%。积极营养态度持有率为76.6%。营养知识得分越高,营养态度越积极(F=2.702,P0.05)。营养行为近1个月以来经常吃早餐的工人占52.3%,积极营养行为持有率为68.0%。其中营养知识得分越高,营养行为越合理(F=21.922,P0.01),营养态度得分越高,营养行为越合理(F=35.769,P0.01);女职工营养行为比男职工更合理(F=13.071,P0.01);不同文化程度的职工,营养行为有统计学差异(F=6.587,P0.01)。结论该企业职工营养知识、态度、行为现状有待进一步提高和改善。其中性别、文化程度对营养知识水平有影响。营养知识对营养态度、行为的作用明显,而营养态度同样对营养有促进作用。由此可见,开展针对性的营养健康教育迫在眉睫。     

早期干预对低出生体重婴儿智能发育及对母亲情绪的影响

目的 分析低出生体重婴儿智能发育及产后母亲情绪变化特点,研究早期干预对低出生体重婴儿智能发育及对母亲情绪的影响。方法 2016年1月-2018年6月选取低出生体重婴儿及其母亲135例,随机分为干预组及对照组,干预组在常规体检的基础上,指导家庭干预训练,分别在婴儿3、9、18月龄时母亲填写抑郁自评量表(SDS)及焦虑自评量表(SAS)进行母亲情绪评估,同时医务人员对婴儿进行Gesell智能发育评估。结果 9月龄时,在大动作、应物及语言能区,干预组与对照组DQ值相比差异有统计学意义(t=2.514、2.032、3.266、P<0.05);18月龄时,在大动作、精细动作、语言能、应物能、应人能5个能区两组差异均有统计学意义(t=2.453、3.063、2.743、2.828、2.853,P<0.05)。用两因素重复测量方差分析对两组DQ值进行整体分析发现:5个能区的时间主效应差异有统计学意义(P<0.05);除粗大动作能区外,其余4个能区干预主效应差异有统计学意义(P<0.05);除语言能区外,其他4个能区的干预因素和时间因素均不存在交互作用(P>0.05)。9月龄时,干预组母亲SDS得分低于对照组,差异有统计学意义(P<0.05)。两组母亲在3、9、18月龄的SDS、SAS得分均呈递减趋势, 时间主效应差异有统计学意义(P<0.05),干预主效应差异无统计学意义(P>0.05)。结论 早期干预能够有效促进低出生体重婴儿智能发育,但对改善产后母亲情绪的作用有限。     

杭州市某区幼儿情绪能力与母亲产后抑郁关系的病例对照研究

目的探讨杭州市某区幼儿情绪能力与母亲产后抑郁的关系,以提供针对性的预防措施。方法于2016年,按照单纯随机抽样的方法,抽取抗州市某区3个社区的幼儿保健门诊和预防接种门诊的12~36月龄幼儿及其母亲381名。采用病例对照研究,以情绪能力异常的幼儿为病例组(69名),情绪能力正常的幼儿为对照组(312名)。单因素分析母亲产后抑郁在病例组和对照组间的分布特点及其与幼儿情绪能力的相关性;应用多重线性回归分析母亲产后抑郁对幼儿情绪能力的影响。结果病例组与对照组母亲产后抑郁程度比较,差异有统计学意义(Z=-3.274,P=0.001);幼儿情绪能力各维度与母亲产后抑郁各维度得分呈正相关。多重线性分析显示,母亲产后抑郁的幼儿的情绪能力的外显域(β=1.292,P=0.001)、活动度/冲动性(β=0.480,P=0.002)、攻击性/反抗性(β=0.825,P0.001)、内隐域(β=1.752,P0.001)、忧郁/退缩(β=0.416,P0.001)、焦虑(β=0.549,P0.001)得分更高,异常风险更高。结论幼儿情绪能力异常与母亲产后抑郁呈正相关。建议培养幼儿情绪能力的同时,也要积极预防治疗母亲产后抑郁。     

注意缺陷多动障碍与对立违抗障碍男童的情绪调节过程缺陷

目的 探索注意缺陷多动障碍(ADHD)和对立违抗障碍(ODD)男童的情绪调节过程特征,比较两者情绪调节过程的异同。方法 采用病例对照的研究方法,选取ADHD和ODD男童为研究组,对其情绪调节能力、行为表现、智能情况进行评估,并且与健康发育男童做比较。结果 以总智商为协变量,研究组在负性情绪认知重评,负性情绪表情抑制,负性情绪表情宣泄,正性情绪认知重评上的得分与对照组比较,差异有统计学意义(F=4.108、7.747、12.157、4.475,P<0.05或<0.01);单纯ODD组、ODD/ADHD组和单纯ADHD组的情绪调节能力未见显著差异。结论 ADHD和ODD男童存在对负性情绪的调节缺陷。     

应对方式在妊娠期糖尿病孕妇心理弹性与负性情绪间的中介效应

目的以妊娠期糖尿病孕妇作为研究重点,观察应对方式在心理弹性及负性情绪间的中介效应。方法2021年5月至9月采用简易应对方式问卷、心理弹性量表及抑郁-焦虑-压力量表对郑州市两所三级甲等医院240例确诊妊娠期糖尿病的孕妇进行问卷调查。结果有无不良孕产史孕妇心理弹性、应对方式、负性情绪得分比较,差异有统计学意义(P<0.05);直系亲属是否患糖尿病孕妇的消极应对、负性情绪(抑郁、焦虑、压力)得分及不同文化程度孕妇心理弹性、消极应对、负性情绪(抑郁、焦虑、压力)得分比较,差异有统计学意义(P<0.05)。积极应对与心理弹性呈正相关,与负性情绪呈负相关,消极应对与负性情绪呈正相关(P<0.05)。积极应对得分越高导致负性情绪得分越低(B=-0.583,P<0.001);消极应对得分越高,负性情绪得分越高(B=1.094,P<0.001);对于心理弹性、负性情绪而言,应对方式能够起到良好的中介效应。结论应对方式在妊娠期糖尿病孕妇心理弹性与负性情绪间存在中介作用,提示应重点关注低心理弹性孕妇,培养建立积极的应对方式,从而降低其负性情绪,提高心理健康水平。     

Premature and full term infants: Maternal influence on psychomotor development -- age 0-6 months

Psychomotor development and maternal stimulating care during ages 0-6 months was compared among premature and full-term infant - mother - pairs using a two group comparative design. The data was analysed using a f-test of difference, standard deviation and means. Psychomotor development evidenced significant difference only during the first and second months of birth after which there was no significant difference. The full-term infants received stimulating maternal care during the first, second and third months which was positively related to infants' psycho-motor developments, while the premature infant received stimulating maternal care during the third, fourth and fifth months which was also positively related to psychomotor development. This suggests that psychomotor and infant type comparison cannot be assessed independently of maternal variables surrounding them.     

Zinc Deficiency in Nursing Infants

Zinc deficiency during nursing can occur even in breast-fed infants. Zinc reserves accumulated during fetal development modulate the infant’s susceptibility to zinc deficiency. Improvement of maternal zinc nutrition during pregnancy is the key for infant’s zinc nutritional support and prevention of low-for-lactation-age zinc concentrations of breast-milk.     

The Effects of an Infant Formula Enriched with Milk Fat Globule Membrane,Long-Chain Polyunsaturated Fatty Acids and Synbiotics on Child Behavior up to 2.5 Years Old: The COGNIS Study

Although early life nutrition influences brain development and mental health, the long-term effects of supplemented infant formula on children´s behavior remain unclear. We analyzed the effects of a bioactive nutrients-enriched-infant formula on children’s behavior up to 2.5 years, compared to a standard infant formula or breastfeeding. Current analysis involved 70 children who were fed a standard infant formula (SF, n = 29) or a bioactive compounds enriched-infant formula (EF, n = 41), during their first 18 months of life, and 33 breastfed (BF) children (reference group) participating in the COGNIS study. Behavioral problems were evaluated using the Child Behavior Checklist at 18 months and 2.5 years. Different statistical analyses were performed using SPSS. EF children aged 2.5 years presented fewer pathological affective problems than SF children. Besides, SF children were classified more frequently as bordering on internalizing problems than BF children. Rates of externalizing problems were increased in SF infants compared to EF and BF infants. Higher maternal IQ was found to have beneficial effects on internalizing and total problem rate in their offspring at 18 months of life; finally, higher maternal educational level was related with fewer ADHD problems in children at 18 months, as well as internalizing, externalizing, total and anxiety problems in children aged 2.5 years. Our analysis suggests that enriched infant formula fed infants seem to show fewer behavioral problems up to 2.5 years compared to a standard infant formula-fed infants. In addition to type of early feeding, maternal IQ and educational level seem to play a key role on children behavioral development.     

母亲DHA摄入与胎儿、婴儿DHA营养状况及发育的关系

二十二碳六烯酸 (DHA)对胎儿、婴儿发育的重要生理作用已经引起了营养学界的广泛关注。孕妇和乳母作为胎儿、婴儿营养的主要提供者 ,其DHA营养状况对胎、婴儿DHA营养和发育具有重要影响。在孕期和 (或 )哺乳期补充DHA的母亲 ,其婴儿具有较高的血DHA水平和较好的体格、视力和智力发育水平。本文对国内外有关母亲DHA摄入与胎儿、婴儿DHA营养状况及发育关系的近期研究资料进行了综述。     

河南省0～2岁婴幼儿碘营养状况和喂养方式与生长发育的关系

目的 探讨0～2岁婴幼儿的喂养方式和碘营养状况对其生长发育的影响。方法 采用整群抽样的方法,在河南省的18个省辖市各随机抽取2个县,每个县调查100名0～2岁婴幼儿的尿碘水平、喂养方式、生长指标。利用WHO Anthro软件计算年龄别体重评分（weight for age Z score,WAZ）和年龄别身高评分（height for age Z score,HAZ）。分别采用单因素方差分析和多元线性回归探讨碘营养水平和喂养方式对婴幼儿身高和体重的影响。结果 不同碘营养水平之间,13～18月龄组婴幼儿WAZ差异有统计学意义（F = 2.494,P = 0.043）;不同喂养方式之间,13～18月龄组WAZ差异有显著性（F = 3.040,P = 0.049）,19～24月龄组HAZ差异有统计学意义（F = 3.428,P = 0.034）。在校正了父母亲身高和体重、母亲年龄和文化程度、家庭收入等变量后,多元线性回归分析结果显示:13～18月龄的婴幼儿尿碘水平在50 μg/L以下的婴幼儿体重显著低于尿碘水平在50 μg/L以上的婴幼儿,未发现碘营养水平和身长的相关关系有统计学意义;在13～18月龄组,人工喂养的婴儿比母乳喂养的婴儿体重偏低（t = - 2.381,P = 0.018）;但在19～24月龄组,人工喂养的婴儿比母乳喂养的婴儿身长偏高（t = 2.639,P = 0.009）。结论 碘营养水平对婴儿的生长发育有一定影响,应保持婴儿适宜的碘营养水平。母乳喂养和人工喂养的婴儿生长方式存在一定的差异,但都在正常范围之内。     

Secondhand smoke exposure during pregnancy and infantile neurodevelopment

During prenatal development, the nervous system may be more susceptible to environmental toxicants, such as secondhand smoke. The authors assessed the effects of prenatal and postnatal secondhand smoke exposure on the neurodevelopment of 6-month infants. The subjects were 414 mother and infant pairs with no medical problems, taken from the Mothers' and Children's Environmental Health study. Prenatal and postnatal exposures to secondhand smoke were determined using maternal self-reports. Examiners, unaware of exposure history, assessed the infants at 6 months of age using the Bayley Scales of Infant Development. Bayley scores were compared for secondhand smoke exposed and unexposed groups after adjusting for potential confounders. Multiple logistic regression analysis was carried out to estimate the risk of developmental delay posed by SHS exposure. The multivariate model included residential area, maternal age, pre-pregnancy body mass index, education, income, infant sex, parity, birth weight, and type of feeding. After adjusting for covariates, secondhand smoke exposure during pregnancy was found to be related to a decrease in mental developmental index score, but not to a decrease in psychomotor developmental index score. In addition, secondhand smoke exposure during pregnancy was found to increase the risk of developmental delay (mental developmental index score ≤85) at 6 months. This study suggests that the infants of non-smoking women exposed to secondhand smoke are at risk of neurodevelopmental delay.     

Mental and psychomotor development in Indonesian infants of mothers supplemented with vitamin A in addition to iron during pregnancy

Maternal nutrition is important for fetal development, but its impact on the functional outcome of infants is still unclear. The present study investigated the effects of vitamin A and Fe supplementation during gestation on infant mental and psychomotor development. Mothers of infants from five villages in Indonesia were randomly assigned to supervised, double-blind supplementation once per week from approximately 18 weeks of pregnancy until delivery. Supplementation comprised 120 mg Fe+500 microg folic acid with (n 94) or without (n 94) 4800 microg retinol in the form of retinyl acetate. Mothers of infants who participated in the national Fe+folic acid supplementation programme, but whose intake of supplements was not supervised, were recruited from four other villages (n 88). The mental and psychomotor development of infants was assessed, either at 6 or 12 months of age, using the Bayley Scales of Infant Development (BSID). We found no impact of vitamin A supplementation on mental or psychomotor development of infants. In addition, infants whose mothers had received weekly Fe supplementation had similar mental and psychomotor indices as those whose mothers had participated in the governmental Fe supplementation programme. The study population was moderately Fe and vitamin A deficient. The size of the treatment groups was large enough to detect a mean difference of 10 points on the BSID, which is less than 1 sd (15 points) of the average performance of an infant on the BSID. In conclusion, the present study did not find an impact of weekly supplementation of 4800 RE vitamin A in addition to Fe during gestation on functional development of Indonesian infants. However, smaller improvements in development may be seen if studied in a larger and/or more deficient population.     

维生素D缺乏性佝偻病影响因素的研究

目的 探讨佳木斯地区0～2岁婴幼儿佝偻病的影响因素,为佝偻病的干预提供依据.方法 整群抽取0～2岁临床上有活动期维生素D缺乏性佝偻病症状和体征的婴幼儿159例,同时随机抽取78例0～2岁正常婴幼儿作为对照组.在填写家庭、社会和营养因素调查表的同时进行相应的体格及实验室检查.结果 单因素分析:佝偻病的发生与母孕期每天日照时间、婴幼儿年龄、每天乳制品的摄入量、每天日照时间、是否患有慢性腹泻等疾病、体重、身高等7个变量显著相关.多因素逐步回归分析:母孕期每天日照时间、婴幼儿出生体重、出生身长、出生后至调查时是否补充维生素D、每天乳制品摄入量及每天日照时间,与佝偻病的发生显著相关.结论 母孕期每天日照时间短、婴幼儿年龄小、出生体重重、出生身长短、出生后未及时补充维生素D、每天乳制品摄入量过少及每天日照时间短,是佝偻病发生的危险因素.     

Rich micronutrient fortification of locally produced infant food does not improve mental and motor development of Zambian infants: a randomised controlled trial

It is uncertain whether multiple micronutrients benefit the mental and psychomotor development of young children in developing countries. We conducted a randomised double-blind controlled trial to evaluate the effect of a richly micronutrient-fortified v. a basal fortified porridge on mental and psychomotor development in Zambian infants. Infants (n 743) were randomised at age 6 months to receive either the richly fortified or the basal fortified infant food and were followed up until 18 months of age. All the infants were evaluated monthly for achievement of a series of developmental milestones. The Bayley scales of infant development II were administered to a subsample of 502 infants at 6, 12 and 18 months. Rich micronutrient fortification had no significant benefit on the following: (a) number of developmental milestones achieved (rate ratio at 12 months?=?1·00; 95?% CI 0·96, 1·05; P?=?0·81, adjusted for sex, socio-economic status and maternal education, with similar results at 15 and 18 months); (b) ages of walking unsupported (hazard ratio (HR) 1·04; 95?% CI 0·88, 1·24; P?=?0·63, adjusted for the above covariates) and of speaking three or four clear words (HR 1·01; 95?% CI 0·84, 1·20; P?=?0·94, adjusted for the above covariates); (c) mental development index (MDI) and psychomotor development index (PDI) of the Bayley scales (scores difference adjusted for baseline scores, age at the assessment, sex, socio-economic status, maternal education, language, age and HIV status: MDI 0·3 (95?% CI -?0·5, 1·1), P?=?0·43; PDI -?0·1 (95?% CI -?0·9, 0·7), P?=?0·78). In conclusion, the results do not support the hypothesis that rich micronutrient fortification improves Zambian infants' mental and motor development.     

孕妇、乳母及婴儿补充钙和维生素D对婴儿骨碱性磷酸酶的影响

目的调查研究孕妇、乳母及婴儿补充钙和维生素D的状况与婴儿骨质发育的关系。方法对2006年10月～2008年1月在北京妇产医院儿科就诊的1176例健康母-婴进行面对面的回顾性问卷调查,了解在母亲孕期和哺乳期以及婴儿期补充钙和维生素D的状况,同时检测婴儿全血骨碱性磷酸酶(BAP)的活性,并测量婴儿前囟斜径。用卡方检验和logistic回归对调查结果进行统计分析。结果母亲孕期补钙对婴儿的BAP活性没有显著影响(P=0.154)。在188名纯母乳喂养儿中,母亲在哺乳期补充钙和维生素D,可显著降低婴儿全血BAP的活性(P=0.018)。用logistic回归分析婴儿的喂养方式和是否补充钙和维生素D对婴儿全血BAP活性的影响,结果表明仅婴儿补充钙和维生素D可显著降低全血BAP的活性(P=0.000),而喂养方式对BAP活性没有显著影响影响。对婴儿前囟门大小的分析,42天内婴儿的前囟门大小与BAP活性有明显负关联,但与母亲孕期是否补钙没有关联。结论母亲哺乳期和婴儿补充钙和维生素D可显著降低婴儿全血BAP的活性。婴儿前囟门大小不能作为是否缺钙的判断依据。