儿童弱视的危险因素及预防措施

目的探讨儿童弱视的危险因素及其预防措施。方法选择2015年6月-2016年12月在绍兴第二医院期间确诊的83例弱视儿童为研究对象(观察组),另选择正常体检儿童80例作为对照组。调查两组一般情况包括性别、家族遗传史、家庭情况、家长文化程度、儿童出生时是否吸氧、喂养方式、出生后是否使用抗菌药物、母亲孕次、睡眠时间、体质量、母孕年龄、家长屈光状态、儿童常居环境采光。结果单因素分析表明,两组性别、家庭情况、儿童出生是否吸氧、喂养方式、母孕年龄比较,差异无统计学意义(P>0.05);两组家族遗传史、儿童常居环境采光、母亲孕次、睡眠时间比较,差异有统计学意义(P<0.05)。将上述具有统计学差异的单因素分析结果纳入多因素分析家族遗传史、常居环境采光、母亲孕次及睡眠时间为儿童弱视独立危险因素。结论家族遗传史、儿童常居环境采光、母亲孕次、睡眠时间为儿童弱视独立危险因素。     

四川省自贡市学龄前儿童弱视现状及其影响因素

目的探究四川省自贡市学龄前儿童弱视现状及其影响因素。方法采用分层整群抽样选取四川省自贡市8所幼儿园(城区4个、郊区4个)的学龄前儿童进行弱视检查,收集儿童及母亲资料,经单因素、多因素分析学龄前儿童弱视的影响因素。结果943名学龄前儿童中男468名,女475名;年龄3~6岁,中位年龄[4.00(4.00,5.00)]岁。筛查出弱视47例,患病率为4.98%,其中以屈光不正性弱视为主(36.17%),其次为屈光参差性弱视(34.04%)、斜视性弱视(21.28%)、形觉剥夺性弱视(8.51%)。母亲妊娠期吸烟、妊娠期饮酒、孕次、产次、儿童斜视病史、早产、屈光不正家族史与儿童弱视发生有关(P<0.05或P<0.01)。多因素Logistic回归分析结果显示,母亲妊娠期吸烟(OR=10.450)、产次≥3次(OR=3.508)、儿童斜视病史(OR=16.877)、早产(OR=4.285)、屈光不正家族史(OR=9.075)是学龄前儿童弱视发生的危险因素。结论学龄期儿童弱视的影响因素可能为有斜视病史、早产、屈光不正家族史,以及母亲妊娠期吸烟和产次。     

儿童弱视发病危险因素的病例对照研究

目的探讨儿童弱视患病的主要相关因素,为弱视的一级预防提供参考依据。方法采用1∶1匹配的病例对照研究方法,选取2010-2015年间在本院小儿眼科门诊新确诊的弱视儿童100例,同时选取与病例同性别、同年龄(相差±0.5岁)、同一居住地的健康儿童进行配对研究。应用条件Logistic回归分析法分析弱视患病的相关影响因素。结果多因素Logistic回归分析结果显示,儿童居住环境采光条件不良、母亲怀孕次数多、儿童发锌过低是弱视发生的主要危险因素,而多食海产品则是保护性因素。结论改善儿童居住环境的采光条件,儿童补锌及增加日常膳食中海产品等可在一定程度上降低儿童弱视的发生风险。     

吉林地区儿童先天性心脏病影响因素的病例对照研究

目的 分析吉林地区儿童先天性心脏病(CHD)的非遗传影响因素,寻找降低吉林地区儿童CHD患病风险的针对性策略。方法 选择2019—2020年吉林省出生缺陷上报系统发现的符合纳入标准并愿意配合的70对CHD患儿及其母亲作为病例组,选择同性别、年龄、地区的140对健康儿童及其母亲作为对照组进行1∶2病例对照配对。应用多因素Logistic回归分析模型分析儿童CHD的影响因素。结果 病例组和对照组儿童的性别、年龄分布差异无统计学意义(P>0.05),多因素分析结果显示：早产(OR=6.224)、父亲孕前3个月内饮酒(OR=2.476)、母亲孕前BMI≥25(OR=8.372)是儿童CHD的危险因素(P<0.05),孕期服用复合维生素(OR=0.342)是儿童CHD的保护因素(P<0.05)。结论 早产、父亲孕前3个月内饮酒和母亲孕前BMI≥25是吉林地区儿童CHD发病的危险因素,应重点关注早产儿心脏功能,加强对备孕夫妇保健知识的宣传教育,鼓励其戒烟戒酒、控制体重,做好孕前和孕期保健。     

151例儿童营养不良的病例对照研究

[目的]探讨儿童营养不良的危险因素,为预防儿童营养不良的发生提供科学依据.[方法]按1:2配对原则,以统一的调查表和调查方式对151例病例组患儿和302例对照组儿童进行调查.应用SPSS 10.0软件对调查因素进行单因素和多因素Logistic回归分析.[结果]单因素分析表明母亲文化程度、家庭经济收入低、家庭不和睦、父母离异、母亲不知道合理营养、常吃水果、蔬菜、常吃豆制品和肉蛋奶类食品、偏食、常吃零食、食量小、近2个月内患严重疾病、经常患病等1 4项因素与营养不良发生有关.多因素条件Logistic回归分析发现家庭收入低(OR=3.0419)、家庭不和睦(OR=2.6347)、母亲不知道合理营养(OR=3.2851)、偏食(OR=4.5821)、经常患病(OR=2.1632)是儿童营养不良的危险因素;而母亲文化程度高(OR=0.5162)、经常吃蔬菜(OR=0.4794)、常吃肉蛋奶类(OR=0.2319)是保护因素.[结论]儿童营养不良是多因素综合作用的结果,应采取综合干预措施来控制儿童营养不良的发生.     

学龄儿童营养不良的危险因素分析

[目的]探讨儿童营养不良的危险因素,为预防儿童营养不良提供科学依据。[方法]按1︰1配对的原则对121例营养不良儿童和对照组进行调查,用SPSS13.0软件对调查因素进行单因素和多因素的Logistic回归分析。[结果]单因素分析表明母亲文化程度、家庭经济收入、家庭成员关系、单亲家庭、母亲不知道合理营养、经常吃水果蔬菜、常吃鱼肉蛋奶及豆制品、偏食挑食、常吃零食、食量小、经常患病、近两个月内患严重疾病、经常户外运动等13项因素与儿童营养不良有关。多因素Logistic回归分析发现家庭经济收入低(OR=3.0419)、家庭成员关系紧张(OR=2.6347)、母亲不知道合理营养(OR=3.2851)、偏食挑食(OR=4.5821)、经常患病(OR=2.1632)是儿童营养不良的危险因素,而母亲文化程度高(OR=0.5162)、常吃蔬菜水果(OR=0.4794)、常吃鱼肉蛋奶及豆制品(OR=0.2319)、经常户外运动(OR=0.3168)是儿童营养不良的保护因素。[结论]儿童营养不良是多因素综合作用的结果,应采取综合措施来预防儿童营养不良的发生。     

嘉兴市中小学生肺结核危险因素病例对照研究

探索影响中小学生肺结核发病的主要危险因素,为开展学校肺结核病防控工作提供借鉴.方法 选择2008年1月至2009年12月间,嘉兴市中小学生中经结核病定点医院确诊的现患肺结核患者,进行1:1病例对照研究.结果 单因素分析中,体重、体质量指数、家庭经济条件、学习强度、文体活动强度、母亲文化程度、结核病接触史对中小学生结核患病的影响有统计学意义(P <0.05或P<0.01).多因素分析中,体质量指数<20 kg/m2(OR=8.406),家庭经济条件差(OR=5.781),学习强度大(OR=3.083),有结核病接触史(OR=13.698)是患肺结核病的危险因素;文体活动强度大(OR=0.385)和母亲文化程度高(OR=0.136)是保护因素.结论 中小学生结核病的患病危险因素复杂,自身抵抗力、家庭经济条件、结核病接触情况等与肺结核发病密切相关.     

儿童弱视先天性危险因素的Logistic回归分析

目的:探讨儿童弱视的先天性危险因素,为弱视的防治提供依据。方法:对285例弱视儿童和291例配比条件类同的视力正常的儿童进行病例对照研究,采用非条件Logistic回归分析进行多因素分析,筛选出主要危险因素。结果:父母吸烟、家庭遗传、母亲高龄生育、孕次为主要危险因素。母亲良好的营养状况是儿童弱视的保护性因素。结论:父母吸烟、遗传、母亲高龄生育、多胎生育及孕期营养等先天性因素与儿童弱视的发生有相关性。揭示儿童弱视防治应从婴儿出生前抓起,父母育前指导、母亲妊娠期及围产期保护应予重视。     

三都水族自治县0～6岁儿童智力低下的现患率调查及影响因素分析

目的:了解三都水族自治县(三都县)0～6岁儿童智力低下(MR)的患病情况及其影响因素。方法:于2011年6月～2012年6月,采用分层整群随机抽样的方法对三都县0～6岁儿童1 982名进行问卷调查和MR筛查,并对与MR相关的因素进行单因素及多因素分析。结果:1 982名0～6岁儿童中,确诊MR为59人,现患率为29.77‰。男性儿童确诊为MR 41例,现患率为37.51‰(41/1 093);女性儿童确诊为MR 18例,现患率为20.25‰(18/889),男性儿童MR现患率高于女性儿童,差异有统计学意义(χ2=5.06,P<0.01)。单因素分析显示,年龄、孕周、母亲文化程度、养育方式、居住环境、家庭经济条件、养育习惯、母亲吸烟、母亲饮酒等为影响儿童MR的危险因素(P<0.05)。多因素分析表明,孕周、母亲文化程度、养育方式、居住环境、家庭经济条件为影响儿童MR的独立危险因素。结论:三都县0～6岁儿童MR的患病率高于国内平均水平。影响儿童MR的独立危险因素为孕周、母亲文化程度、养育方式、居住环境、家庭经济条件。     

贵港市农村1～14岁儿童意外中毒危险因素的病例对照研究

目的:探讨农村地区儿童发生意外中毒的危险因素,为儿童意外中毒的预防和干预提供科学依据。方法:采用1∶1匹配的病例对照研究方法,对广西贵港市237例因意外中毒而住院或急诊的1～14岁农村儿童和居住于同一地区、性别、年龄匹配的237例对照儿童进行问卷调查。采用单因素和多因素条件Logistic回归模型分析危险因素。结果:单因素条件Logistic回归分析发现父母非第一监护人、母亲低学历、常外出玩耍、经常吃零食、经常吮手、随意放置鼠药或农药、监护频率高、学校有健康教育课程、知晓中毒预防知识、教育儿童卫生饮食10个因素与发生意外中毒有关。多因素条件Logistic回归分析发现母亲低学历(OR=2.134,P=0.003)、父母非第一监护人(OR=3.219,P=0.000)、常外出玩耍(OR=2.172,P=0.000)、经常吮手(OR=2.367,P=0.001)、随意放置鼠药或农药(OR=2.184,P=0.007)5个因素是危险因素;监护频率高(OR=0.570,P=0.007)、学校有健康教育课程(OR=0.327,P=0.011)、知晓中毒预防知识(OR=0.247,P=0.000)3个因素是保护因素。结论:农村地区儿童意外中毒的发生与健康教育、家庭因素、儿童监护、儿童自身危险行为、毒物管理等因素有关。应针对儿童中毒的危险因素制定综合的预防干预措施。     

Lack of association of mercury with risk of wheeze and eczema in Japanese children: the Osaka Maternal and Child Health Study

Mercury can have profound and complicated effects on the immune system, and epidemiological evidence regarding the relationship between mercury exposure and allergic disorders has been sparse. We investigated the associations between mercury levels in maternal and children's hair and the risk of wheeze and eczema in Japanese children at 29–39 months of age. Study subjects were 582 Japanese mother–child pairs. Presence or absence of wheeze and eczema symptoms was determined based on the criteria of the International Study of Asthma and Allergies in Childhood. Adjustment was made for maternal age; residential municipality at baseline; maternal and paternal education; maternal and paternal history of allergic disorders; maternal energy-adjusted fish intake during pregnancy; maternal smoking during pregnancy; number of child's older siblings; child's sex; household smoking in the same room as the child; breastfeeding duration; and children's fish intake at the fourth survey. The prevalence of wheeze and eczema was 18.6% and 17.2%, respectively. The range of hair mercury levels was 0.26−6.05 μg/g in mothers and 0.13−9.51 μg/g in children. Neither maternal nor children's hair mercury levels were related to the risk of wheeze or eczema. Maternal and children's hair mercury levels in the second quartile were non-significantly inversely related to the risk of wheeze (adjusted odds ratios [95% confidence intervals] were 0.77 [0.41−1.44] and 0.57 [0.29−1.11], respectively) while those in the third quartile were non-significantly inversely associated with the risk of eczema (adjusted odds ratios [95% confidence intervals] were 0.77 [0.40−1.45] and 0.66 [0.33−1.30], respectively). The current study provides no evidence that hair mercury levels in either mothers or children are positively associated with the risk of wheeze or eczema in children aged 29–39 months in Japan, where fish intake is high.     

Parent Reactions to a School-Based Body Mass Index Screening Program

Background:  This study assessed parent reactions to school-based body mass index (BMI) screening.
Methods:  After a K-8 BMI screening program, parents were sent a letter detailing their child's BMI results. Approximately 50 parents were randomly selected for interview from each of 4 child weight–classification groups (overweight, at risk of overweight, normal weight, underweight) to assess parent recall of the letter, reactions to BMI screening, and actions taken in response to the child's BMI results.
Results:  Most parents found the BMI screening letter easy to read and had poor recall of numerical information (eg, the child's BMI percentile) but good recall of the child's weight classification (eg, normal weight or overweight). Most parents, and ethnic-minority parents in particular, supported school-based BMI screening. Parents of children whose weight was outside of the normal range were more likely to recall receiving the letter and talking to the child and the child's doctor about it. Parents who recalled their child as being overweight were more likely to report changing the child's diet and activity level. Most parents, and ethnic-minority parents in particular, wanted their child to participate in an after-school exercise program. An overweight condition in parents, but not children, was associated with an interest in family-based cooking and exercise classes.
Conclusions:  Most parents, and ethnic-minority parents in particular, viewed school-based BMI screening and after-school exercise programs favorably. Parents reported taking action in response to a BMI result outside of the normal range. Parents who were overweight themselves were particularly interested in family cooking and exercise classes.     

Children's television viewing, body fat, and physical fitness

PURPOSE: The study examines the relationship between children's television (TV) viewing and physical fitness. DESIGN: Cross-sectional data from questionnaires and objective measures were analyzed. SETTING: Data were collected during the fall of 1990 from public elementary school students in a suburban California city. SUBJECTS: Approximately 98% of eligible students participated. Of these, 10% were dropped due to missing data, yielding a final sample of 284 girls and 304 boys. MEASURES: Children reported their amount of TV viewing on a typical summer day; parents reported their child's TV viewing on a typical weekday during the school year. Cardiovascular fitness was the 1-mile run/walk. Body fat was both the child's body mass index (BMI) and skinfolds. Additional measures included muscular strength/endurance and flexibility. RESULTS: Mile run/walk times were associated with both parental (eta 2 = .051 and .031 for boys and girls, respectively) and child reports (eta 2 = .020 and .028) of the child's amount of TV viewing. Parental reports, but not child reports, of the child's TV viewing were related to BMI (eta 2 = .041 and .058) and skinfolds (eta 2 = .050 and .029). Neither measure of children's TV viewing was related to muscular strength/endurance or flexibility. CONCLUSIONS: Children's TV viewing seems to be weakly and inconsistently related to various components of physical fitness. However, given the tracking of cardiovascular disease risk factors from childhood into adulthood and the high proportion of children who watch television, these relationships are worthy of further study.     

"Childhood overweight and obesity: maternal perceptions of the time for engaging in child weight management"

ABSTRACT: BACKGROUND: There is an increasing awareness of the impact of parental risk perception on the weight course of the child and the parent's readiness to engage in preventive efforts, but only less is known about factors related to the parental perception of the right time for the implementation of preventive activities. The aim of this study was to examine parental perceptions of the appropriate time to engage in child weight management strategies, and the factors associated with different weight points at which mothers recognize the need for preventive actions. METHODS: 352 mothers with children aged 2-10 years took part in the study. We assessed mothers' perceptions of the actual and preferred weight status of their child, their ability to identify overweight and knowledge of its associated health risks, as well as perceptions of the right time for action to prevent overweight in their child. A regression analysis was conducted to examine whether demographic and weight related factors as well as the maternal general risk perception were associated with recognizing the need to implement prevention strategies. RESULTS: Although most of the parents considered a BMI in the 75th to 90th percentile a valid reason to engage in the prevention of overweight, 19% of the mothers were not willing to engage in prevention until their child reached the 97th percentile. Whereas the child's sex and the identification of an elevated BMI were significant predictors for parents' recognition of the 75th percentile as right point to engage in prevention efforts, an inability to recognize physical health risks associated with overweight silhouettes emerged as a significant factor predicting which parents would delay prevention efforts until a child's BMI reached the 97th percentile. CONCLUSION: Parental misperceptions of overweight and associated health risks constitute unfavorable conditions for preventive actions. Feedback on the health risks associated with overweight could help increase maternal readiness for change.     

压力性尿失禁危险因素流行病学调查研究

目的:探讨影响压力性尿失禁(SUI)发生的危险因素。方法:选取上海地区确诊压力性尿失禁且已手术的女性患者100例,对照组100例,设计统一流行病学问卷进行调查,采用单因素和多因素Logistic回归分析。结果:单因素分析结果:病例组与对照组体重指数(BMI)、结婚年龄、怀孕次数、分娩次数、经阴道分娩次数、初产或阴道分娩有会阴撕裂或感染史、会阴切开次数、初产后体力劳动开始时间、产褥期有尿失禁史、反复尿路感染、习惯性便秘、职业的体力劳动程度、工作时平均站立时间、被动吸烟方面差异有统计学意义(P0.01)。在初产前有尿失禁史、老年性慢性支气管炎、慢性咳嗽、糖尿病、经常感冒、开腹全子宫(+附件)切除术方面差异有统计学意义(P0.05)。多因素分析结果:BMI、会阴撕裂史、产褥期有尿失禁史、习惯性便秘、经常感冒、开腹全子宫(+附件)切除术、结婚年龄、初产后体力劳动开始时间与SUI有显著相关性(P0.01)。患老年性慢性支气管炎与SUI有相关性(P0.05)。结论:肥胖、怀孕次数、分娩次数、经阴道分娩次数、会阴切开次数、阴道分娩或初产有会阴撕裂或感染史、初产前或产褥期有尿失禁史、患老年性慢性支气管炎、慢性咳嗽、糖尿病、反复尿路感染、习惯性便秘、经常感冒、全子宫切除术、从事重体力劳动的职业、工作时平均站立时间长是压力性尿失禁的危险因素;而结婚年龄晚、初产后体力劳动开始时间晚是压力性尿失禁的保护因素。     

不同孕前BMI孕妇孕早期增重对妊娠期糖尿病的影响

目的探讨不同孕前身体质量指数(BMI)孕妇孕早期增重与妊娠期糖尿病(GDM)的关系。方法采用前瞻性队列研究,选取2017年12月至2019年12月在湖北医药学院附属国药东风总医院建档产检孕妇491例,专人记录孕妇的身高、年龄、孕前体重、BMI、孕早中期体重、分娩结局等一般信息,采用Logistic回归分析不同孕前BMI的孕妇孕早期体重增长与GDM的关系。结果孕早期增重不足、适宜及过多的孕妇GDM发病率比较差异有统计学意义(χ²=8.417,P<0.05),而孕中期不同的体重增长情况,孕妇GDM发病率差异无统计学意义(χ²=0.951,P>0.05)。孕早期增重按不同孕前BMI进行分组,Logistic回归分析显示:孕前BMI为18.5~24.9kg/m²的孕妇,孕早期增重过多,GDM发病风险增至1.913倍(OR=1.913,95%CI:1.033~3.543);孕前BMI≥25.0kg/m²的孕妇,孕早期增重适宜、过多,GDM的发病风险分别增至4.900倍(OR=4.900,95%CI:1.179~20.373)和5.444倍(OR=5.444,95%CI:1.290~22.976)。孕前BMI<18.5kg/m²的孕妇,孕早期增重不足、适宜、过多,妊娠期高血压疾病(χ²=118.600)、羊水异常(χ²=6.750)及剖宫产(χ²=6.166)的发生差异有统计学意义(均P<0.05);孕前BMI≥25.0kg/m²的孕妇,孕早期增重不足、适宜、过多,巨大儿发生率差异有统计学意义(χ²=19.372,P<0.05);孕前BMI=18.5~24.9kg/m²的孕妇,孕早期不同增重情况,其不良妊娠结局差异无统计学意义(均P>0.05)。结论孕前体重正常和孕前超重肥胖者,孕早期体重增长过多增加了GDM发生风险;而孕前低体重者,孕早期体重增长增加了妊娠期高血压疾病、羊水异常及剖宫产的发生风险,并不增加GDM的发生风险。     

足月产小于胎龄儿孕妇危险因素病例-对照研究

目的　探索影响胎儿出生体重的危险因素。方法　采用 1∶1匹配的病例对照研究方法 ,收集了足月产小于胎龄儿 (SGA)及其对照共 1 5 5对。应用条件Logistic回归分析方法和相加模型对危险因素及其交互作用进行分析。结果　产妇孕前体重低 (≤ 5 2kg)、孕期体重增加少 (≤ 1 6kg)、被动吸烟和喝茶、孕期及怀孕之前 3个月内进行过染发、烫发或油、配偶身高低 (≤ 1 73cm)以及产妇体重指数大 (≥ 1 9)等与SGA的发生有显著性关联 (P <0 0 5 ) ,在调整了其他危险因素后 ,OR分别为 2 0 8、2 83、3 4 2、2 72、5 6 7、2 92和 0 4 1 ,其中产妇孕前体重低与孕期体重增加少、孕期及怀孕之前 3个月内进行过染发、烫发或油、配偶身高低和孕期被动吸烟之间存在正交互作用。结论　产妇孕前体重低 ,孕期体重增加少、被动吸烟和喝茶、孕期及怀孕之前 3个月内进行染发烫发或油以及配偶身高低等是SGA的危险因素 ,产妇体重指数大是SGA的保护因素