早产影响因素的多分类Logistic回归分析

目的探讨早产儿发生的危险因素.方法采用病例对照研究法对227名早产儿(孕周＜33周73人,33～36周154人)和750名对照组进行相关因素调查,用多分类Logistic回归分析法进行危险因素分析.结果与分娩孕周＜33周早产儿有关的因素是:母亲孕前体质指数≥28者、有人工流产史、孕早期发热、母亲文化水平为小学及以下者,首次产前检查血红蛋白低于100g/L者、尿蛋白和尿糖阳性等因素是分娩孕周＜33周早产儿的危险因素.与分娩孕周在33～36周早产儿有关的因素有:母亲分娩年龄大于35岁、母亲孕期吸烟及饮酒、年家庭收入低及父亲吸烟等因素.父亲职业为农民、多胎妊娠、孕期精神刺激、产前检查次数少、前置胎盘和妊高症等因素是二者的共同危险因素.结论早产是多种因素联合作用的结果,应采取综合性措施降低早产儿的发生率.     

2011年深圳市光明新区婴儿喂养方式现状调查

目的了解光明新区婴儿喂养方式现状,比较独生子女与非独生子女之间的差异,研究两个群体有效的营养行为干预模式。方法 2011年7月1～8日在深圳市光明新区社区儿童保健门诊,对330名0～3岁散居婴幼儿的主要照顾者进行回顾性调查,调查表由医务人员填写,主要内容包括婴幼儿基本情况、喂养现状及补充食品添加情况,以及家长关于婴儿期喂养、营养知识和行为等。结果独生子女家庭年均收入与非独生子女家庭年均收入差异均无统计学意义（P〉0.05）;独生子女母乳喂养率为35.13%,非独生子女为76.08%（P〈0.05）;断奶时间：独生子女为4.10月,非独生子女为8.08月（P〈0.05）;6个月龄时独生子女补充食品添加占29.87%,非独生子女占19.19%（P〈0.01）,两人群补充食品添加种类和频率差异均有统计学意义。结论科学合理的喂养方式取决于主要抚养人的喂养行为以及母亲的文化程度,家庭收入不是科学喂养的主要障碍,独生子女补充食物添加及喂养方式更为科学合理,分层次践行科学育儿中心-社区-家庭的干预模式。     

Predictors of sleep disturbances in the first year of life: a longitudinal study

ObjectiveThe aim of this study was to identify early predictors of nocturnal awakenings and short sleep duration during the first year of life, in terms of sleep habits and patterns. We also analyzed the trend of nocturnal awakenings and total sleep duration from 3 to 12 months of age.MethodsThe parents of 704 infants (49.3% female) were interviewed during their first year of life. The interview included questions on infant sleep (eg, sleep habits, sleep duration, number of nocturnal awakenings) and maternal perception of infant sleep difficulties.ResultsThe study results indicate that most of the infants at risk, with three or more nocturnal awakenings or ≤10 h of total sleep duration in the early months of life, tend to display a similar pattern of sleep problems at 12 months. The main early predictors of sleep problems at 12 months were sleep duration, sleep initiation method, and nocturnal awakenings. More specifically, infants with three or more nocturnal awakenings or ≤10 h of total sleep duration at 12 months were those with a higher number of awakenings during the night and a shorter sleep duration, at both three and six months. In addition, infants at risk for sleep problems at 12 months had an independent sleep initiation method at three months, whereas these same infants had a nonindependent sleep initiation method at six months.ConclusionsOur study identified the early predictors of sleep problems at 12 months. Caregivers should identify these early symptoms in infants to prevent possible sleep difficulties in later years.     

Asthma diagnosis in infants and preschool children: a systematic review of clinical guidelines

Background and aim

The definition and diagnosis of asthma are the subject of controversy that is particularly intense in the case of individuals in the first years of life, due to reasons such as the difficulty of performing objective pulmonary function tests or the high frequency with which the symptoms subside in the course of childhood. Since there is no consensus regarding the diagnosis of asthma in preschool children, a systematic review has been carried out.

Influence of intra- and extrauterine factors on infant sleep in the first 6 months of life

ObjectiveInfant sleep problems can affect the child's health. Maternal characteristics have been associated with the quality of infant sleep, but few studies have investigated the impact of intrauterine conditions. The aim of the study was to evaluate the association between adverse intrauterine environments (maternal smoking, hypertension, diabetes, and intrauterine growth restriction) and extrauterine factors on infant sleep in the first 6 months of life.MethodsProspective cohort study, including singleton and at-term infants. Mothers were interviewed after delivery and at 30 days, 3 months, and 6 months of life. Socioeconomic, breastfeeding, and sleep data were self-reported by mothers using semi-structured interviews. Maternal stress (Perceived Stress Scale) and postpartum depression symptoms (Edinburgh Postpartum Depression Scale) were assessed.ResultsThere was no statistically significant association between intrauterine environments and the sleep of infants of the 359 mother–child dyads investigated. Total infant sleep time decreased from approximately 13–11 h from 30 days to 6 months of age (p < 0.001) and the longest period of uninterrupted sleep increased from approximately 4–6 h during the same period (p < 0.001). Breastfed infants slept longer in 24-h periods in the first month, but they woke up more often throughout the night when compared to infants receiving formula. Mothers with depressive symptoms reported increased sleep latency time.ConclusionsAdverse intrauterine environments did not significantly affect sleep measures in the first 6 months of life. Maternal characteristics and practices, however, were associated with infant sleep, suggesting that environmental factors significantly contribute to sleep quality early in life.