母亲养育实践与婴幼儿饮食行为对儿童超重肥胖影响的研究

目的 本研究探讨母亲养育实践与婴幼儿饮食行为对儿童超重肥胖的影响。方法 采用目的抽样法,选取徐州市2所医院及2个社区卫生服务中心的6 ~ 24月龄婴幼儿及其母亲为研究对象,母亲完成婴幼儿喂养类型和饮食行为问卷。根据儿童身长和体重,计算年龄别体质指数Z值（body mass index - for age z - score,BMIZ）,BMIZ + 2为儿童超重肥胖。采用二元logistic回归分析母亲养育实践与婴幼儿饮食行为对儿童超重肥胖的影响。结果 本研究共回收882份有效问卷,儿童超重肥胖发生率为15.65%。二元logistic回归结果表明,敏感型养育（OR = 0.234,95%CI:0.159 ~ 0.344）,饱腹反应（OR = 0.467,95%CI:0.336 ~ 0.649）和进食缓慢的饮食行为（OR = 0.737,95%CI:0.552 ~ 0.984）是儿童超重肥胖的保护因素;食物反应的饮食行为（OR = 2.369,95%CI:1.797 ~ 3.122）,限制（OR = 2.359,95%CI:1.530 ~ 3.640）和纵容型养育（OR = 1.743,95%CI:1.250 ~ 2.431）是儿童超重肥胖的危险因素。结论 敏感型养育,饱腹反应和进食缓慢的饮食行为降低儿童超重肥胖的发生风险;食物反应的饮食行为,限制和纵容型养育增加儿童超重肥胖的发生风险。     

Factors associated with preterm birth in Campina Grande, Paraíba State, Brazil: a case-control study

A case-control study (2008-2009) analyzed risk factors for preterm birth in the city of Campina Grande, Paraíba State, Brazil. A total of 341 preterm births and 424 controls were included. A multiple logistic regression model was used. Risk factors for preterm birth were: previous history of preterm birth (OR = 2.32; 95%CI: 1.25-4.29), maternal age (OR = 2.00; 95%CI: 1.00-4.03), inadequate prenatal care (OR = 2.15; 95%CI: 1.40-3.27), inadequate maternal weight gain (OR = 2.33; 95%CI: 1.45-3.75), maternal physical injury (OR = 2.10; 95%CI: 1.22-3.60), hypertension with eclampsia (OR = 17.08; 95%CI: 3.67-79.43) and without eclampsia (OR = 6.42; 95%CI: 3.50-11.76), hospitalization (OR = 5.64; 95%CI: 3.47-9.15), altered amniotic fluid volume (OR = 2.28; 95%CI: 1.32-3.95), vaginal bleeding (OR = 1.54; 95%CI: 1.01-2.34), and multiple gestation (OR = 22.65; 95%CI: 6.22-82.46). High and homogeneous prevalence of poverty and low maternal schooling among both cases and controls may have contributed to the fact that socioeconomic variables did not remain significantly associated with preterm birth.     

广州市儿童生命早期因素与超重肥胖的关联

  目的  探讨广州市6~11岁儿童生命早期因素与超重肥胖之间的关系, 为儿童超重肥胖的预防提供科学依据。  方法  基线采用分层整群随机抽样的方法, 于2017年抽取广州市5所小学共5 172名学生作为研究对象, 进行2年的随访, 最终纳入学生3 315名。通过问卷调查收集学生的生命早期因素, 并测量基线和随访中身高和体重等指标。采用Logistic回归分析儿童生命早期因素与超重肥胖的关系。  结果  广州市6~11岁儿童超重肥胖发生率为8.7%。校正混杂因素后, Logistic回归分析显示, 母亲孕前消瘦的儿童超重肥胖发生风险比母亲孕前正常体重的儿童降低了46%(OR=0.54, 95%CI=0.38~0.76);母亲孕期增重过多的儿童超重肥胖发生风险比孕期增重正常的儿童增加了55%(OR=1.55, 95%CI=1.14~2.10);与自然分娩儿童相比, 剖宫产的儿童超重肥胖发生风险增加了30%(OR=1.30, 95%CI=1.00~1.68)(P值均 < 0.05)。  结论  母亲孕期增重过多和剖宫产增加儿童超重肥胖的发生风险, 母亲孕前消瘦降低儿童超重肥胖的发生风险。     

Household smoking and respiratory disease in under-five children

Environmental tobacco smoke is an important respiratory tract irritant in young children. To identify factors associated with respiratory disease and determine the main source of smoking exposure in the household, a cross-sectional study of 2,037 children who were immunized in primary health care clinics was conducted (in a sample of 10 out of 38 clinics with 200 children each). Parents answered a questionnaire about children's birth, passive smoking, former and current respiratory morbidity, socio-demographic characteristics, and living conditions. Analysis was based on hierarchical logistic regression. Prevalence of respiratory symptoms was 59.9% for children who live with smokers. Asthma and bronchitis showed the strongest association with smoking. In multivariate logistic regression, the following variables remained associated with asthma/bronchitis: socioeconomic status (OR = 2.93; 95%CI: 1.57-5.45), maternal schooling (OR = 1.46; 95%CI: 1.08-1.98)] and occupation (OR = 1.68; 95%CI: 1.04-2.74), neighborhood (OR = 1.47; 95%CI: 1.06-2.02), child's age (OR = 3.38; 95%CI: 2.31-4.95) and sex (OR = 1.46; 95%CI: 1.09-1.94), breastfeeding (OR = 1.66; 95%CI: 1.15-2.40), and household smoking (OR = 1.58; 95%CI: 1.18-2.11). Children with lower socioeconomic status and exposed to household smoking showed increased risk of respiratory disease.     

Prevalence and factors associated with sedentary behavior in adolescents

OBJECTIVE

To analyze the prevalence of sedentary behavior and associated factors in adolescents.

METHODS

A cross-sectional study with adolescents aged 10 to 17 years, of both sexes, belonging to a 1994-1999 birth cohort in the city of Cuiabá, MT, Central Western Brazil. Data were collected using a questionnaire containing sociodemographic, economic, lifestyle and anthropometric variables. Sedentary behavior was determined as using television and/or computer/video games for a time greater than or equal to 4 hours/day. Associations with sedentary behavior were evaluated using body mass index in childhood and adolescence and sociodemographic and behavioral variables using hierarchical logistic regression.

RESULTS

The overall prevalence of sedentary behavior was 58.1%. Of the 1,716 adolescents evaluated, 50.7% (n = 870) were male. In multivariate analysis, after adjustment for confounding factors, the variables that remained associated with sedentary behavior were: age (14 and over) (OR = 3.51, 95%CI 2.19;5.60); higher socioeconomic class (OR = 3.83, 95%CI 2.10;7.01), higher level of maternal education (OR = 1.81, 95%CI 1.09;3.01); living in the country (OR = 0.49, 95%CI 0.30;0.81); insufficient physical activity (OR = 1.25, 95%CI 1.02;1.53); experimentation with alcoholic beverages (OR = 1.34, 95%CI 1.08;1.66) and being overweight in adolescence (OR = 1.33, 95%CI 1.06;1.68).

CONCLUSIONS

The high proportion of adolescents in sedentary activities and the lack of association with being overweight in childhood, indicates the need for educational initiatives to reduce multiple risk behaviors. Encouraging physical activity in young people as a way of reducing sedentary behavior and, consequently, being overweight is fundamental.     

Additive interactions of maternal prepregnancy BMI and breast-feeding on childhood overweight

OBJECTIVE: To examine the interactions of maternal prepregnancy BMI and breast-feeding on the risk of overweight among children 2 to 14 years of age. RESEARCH METHODS AND PROCEDURES: The 1996 National Longitudinal Survey of Youth, Child and Young Adult data in the United States were analyzed (n = 2636). The weighted sample represented 51.3% boys, 78.0% whites, 15.0% blacks, and 7.0% Hispanics. Childhood overweight was defined as BMI >/=95th percentile for age and sex. Maternal prepregnancy obesity was determined as BMI >/=30 kg/m(2). The duration of breast-feeding was measured as the weeks of age from birth when breast-feeding ended. RESULTS: After adjusting for potential confounders, children whose mothers were obese before pregnancy were at a greater risk of becoming overweight [adjusted odds ratio (OR), 4.1; 95% confidence interval (CI), 2.6, 6.4] than children whose mothers had normal BMI (<25 kg/m(2); p < 0.001 for linear trend). Breast-feeding for >/=4 months was associated with a lower risk of childhood overweight (OR, 0.6; 95% CI, 0.4, 1.0; p = 0.06 for linear trend). The additive interaction between maternal prepregnancy obesity and lack of breast-feeding was detected (p < 0.05), such that children whose mothers were obese and who were never breast-fed had the greatest risk of becoming overweight (OR, 6.1; 95% CI, 2.9, 13.1). DISCUSSION: The combination of maternal prepregnancy obesity and lack of breast-feeding may be associated with a greater risk of childhood overweight. Special attention may be needed for children with obese mothers and lack of breast-feeding in developing childhood obesity intervention programs.     

Prevalence of pre-hypertension and arterial hypertension and evaluation of associated factors in children and adolescents in public schools in Salvador, Bahia State, Brazil

This study aimed to assess pre-hypertension and hypertension-related factors in 1,125 seven- to-14-year-old subjects enrolled in the public school system in Salvador, Bahia State, Brazil. Exposure variables, namely body mass index, waist circumference, gender, age, physical activity, environmental and housing status, family income, diet, schooling, and maternal age were analyzed by polytomous logistic regression, and the outcome variable was categorized as normal, pre-hypertensive, and hypertensive. Prevalence of high blood pressure was 14.1%, including the prevalence of both hypertension (4.8%) and pre-hypertension (9.3%). An association was shown between pre-hypertension and overweight (OR: 3.13; 95%CI: 1.75-5.57). Hypertension was associated with overweight (OR: 3.02; 95%CI: 1.45-6.28), female gender (OR: 2.49; 95%CI: 1.24-4.98), and high-risk eating patterns (OR: 1.93; 95%CI: 1.04-3.56). In short, prevalence of pre-hypertension and hypertension in children and adolescents was higher among girls and individuals with overweight and inadequate diet.     

Avoidable infant mortality and associated factors in Porto Alegre, Southern Brazil, 2000-2003

A case-control study was performed to investigate the association between the categories avoidable and non-avoidable death and socio-demographic, maternal reproductive, and neonatal status. The study used multivariate logistic regression according to a hierarchical model to analyze 1,139 infant deaths from 2000 to 2003. The variables sex, maternal age, number of live born infants, type of pregnancy, place of birth, and 5-minute Apgar were not associated with avoidable deaths. However, maternal schooling 相似文献   

Asociación entre lactancia materna y probabilidad de obesidad en la infancia en tres países latinoamericanos

ObjectiveTo determine if breastfeeding for at least the first six months of life is associated with overweight and obesity in children 2 to 5 years old.MethodCross sectional analysis of data from national demographic and health surveys conducted in Bolivia, Colombia and Peru. Overweight and obesity were defined using World Health Organization standard definitions. Odds ratios (OR) were calculated using multinomial logistic regression.ResultsThe prevalence of obesity in children 2 to 5 years old was 10.4% (95% confidence interval [95%CI]: 8.2-12.6) in Bolivia, 4.9% in Colombia (95%CI: 4.0-5.8), and 6.4% (95%CI: 5.2-8.0) in Peru. Prevalence of exclusive breastfeeding for at least the first 6 months in the study population was 89.9% (95%CI: 87.8-91.9) in Bolivia, 73.9% (95%CI: 72.2-75.6) in Colombia, and 92.8% (95%CI: 91.2-92.4) in Peru. Exclusive breastfeeding was associated with a decreased risk of obesity in children as compared to no breastfeeding or breastfeeding for less than 6 months in Bolivia (OR = .30; 95%CI: .16-.57) and a marginal association in Colombia (OR = .71; 95%CI: .47-1.06) and Peru (OR = .49; 95%CI: 0.23-1.04). No association between breastfeeding and overweight was found.ConclusionExclusive breastfeeding for at least the first six months of life decreases the risk of obesity in children 2 to 5 years old in Bolivia. A similar but weaker pattern was observed for children in Colombia and Peru.     

Risk factors for maternal mortality in an urban area of Northeast Brazil

A case-control study was conducted to investigate risk factors for maternal mortality in Recife, Pernambuco State, Brazil, in 2001-2005. Cases were 75 maternal obstetric deaths in Recife, identified from the Mortality Information System, investigated and analyzed by an expert committee on maternal mortality. Controls, selected from the Information System on Live Births using systematic sampling, were 300 women living in Recife whose last pregnancy occurred during the same period and ended in live births. Increased risk of maternal death was associated with use of the public health system (OR = 4.47; 95%CI: 1.87-10.29), age > 35 years (OR = 3.06; 95%CI: 1.59-5.92), < 4 years of schooling (OR = 4.95; 95%CI: 2.43-10.08), cesarean section (OR = 3.06; 95%CI: 1.77-5.29), and lack of prenatal care or fewer than four prenatal visits (OR = 9.78; 95%CI: 5.52-17.34). The results confirm social inequalities in maternal mortality in Recife and indicate the need to improve healthcare for women during the prenatal period, delivery, and postpartum.     

Influence of Behavioral and Environmental Factors on the Development of Obesity in Three-year-old Children —A Case-Control Study Based on Toyama Study—

Obesity in children seems to be a risk factor for chronic diseases in adulthood. From the viewpoint of preventive medicine, factors influencing the development of obese children should be removed early in life. The purpose of this study was to the elucidate relationship between obesity in 3-year-old children and both behavioral and environmental factors by conducting a case-control study. Subjects were selected from the Toyama study. Matched-pair comparisons were performed between obese children whose Kaup’s index was 18 or more (N=117) and control children (N=234) . Multivariate stepwised logistic regression analysis also applied to assess influence of confounding factors. The results indicated that the following 6 factors significantly influenced the development of obese 3-year-old children in exact Fisher’s method analysis (p<0.05): person other than the mother responsible for taking care of the child, short sleep duration (9 hours or less), physical inactivity, eating snacks irregularly, overweight father (BMI≥24), and overweight mother (BMI≥24). For both sexes, after adjusting for confounders by multivariate stepwise logistic analysis, overweight mother (OR 2.54, 95 % CI 1.64-3.95), birth overweight (birth weight≥3,500g; OR 1.76, 95 % CI 1.15-2.69), the mother not responsible for taking care of the child (OR 1.65, 95% CI 1.10-2.48), overweight father (OR 1.62, 95%CI 1.09-2.40), eating snacks irregularly (OR 1.56, 95% CI 1.04-2.33), and gender (female;OR 0.51, 95% CI 0.34-0.77) had significant relationships with obesity in childhood. For boys, overweight mother (OR 2.53, 95 % CI 1.47-4.35), birth overweight (OR 2.03, 95%CI 1.22-3.39), eating snacks irregularly (OR 1.94, 95 %CI 1.19-3.18), and birth month (36-41 months; OR 0.47, 95 % CI 0.23-0.96) had significant relationships. For girls, overweight mother (OR 2.62, 1.28-5.35), and short sleep duration (OR 2.24, 1.11-4.52) had significant relationships. In neither Fisher’s exact method nor multivariate logistic models, time to wake up, bedtime, duration of playing outdoors, regularity of meals, care about salty food, or frequency of eating snacks had significant relations with obesity in 3-year-old children (p<0.05).     

Nutritional status and factors associated with stunting in children attending public daycare centers in the Municipality of São Paulo, Brazil

This study reports the nutritional status of children attending daycare centers in the Municipality of S?o Paulo, Brazil. A representative sample of 827 children under 84 months of age was evaluated. Anthropometric measurements and information on socioeconomic characteristics and morbidity were collected. The most prevalent nutritional deficit was stunting (7.0%; 95%CI: 3.60-10.40). Univariate analysis showed a significant association between stunting and age (< 24 months), OR = 2.10 (95%CI: 1.11-3.98); diarrhea one month prior to the data collection, OR = 2.84 (95%CI: 1.42-5.66); mother's or caregiver's schooling (< 3 years), OR = 3.87 (95%CI: 1.10-13.68); number of household members (> 7), OR = 3.02(95%CI: 1.46-6.22); and number of siblings (> 2) OR = 4.81 (95%CI: 1.72-13.44). In the multivariate analysis, only diarrhea one month prior to the data collection, OR = 2.54 (95%CI: 1.20-5.38) and > 2 siblings, OR = 7.40 (95%CI: 2.20-24.93), remained associated with stunting.     

Childhood brain tumor risk in relation to birth characteristics

A population-based case-control study was conducted utilizing linked cancer registry and birth certificate data to examine potential associations between selected birth characteristics and the occurrence of brain tumors in children. Cases (n = 157) were those children ages 10 and under who were born in Washington state and who were diagnosed with a primary brain tumor between 1974 and 1986. Controls were randomly selected from the Washington State birth files and were matched 5:1 to cases on year and county of birth. A limited number of positive findings emerged from the study. Results suggested that high birthweight may be related to an increased risk of childhood brain tumor (odds ratio (OR) = 1.4, 95% CI 1.0-2.0 for all histologies combined; OR = 1.9, 95% CI 1.1-3.1 for astrocytomas). The risk of astrocytoma was also observed to be associated with older maternal age (OR = 2.2, 95% CI 1.2-4.0) and a history of prior fetal death(s) (OR = 1.9, 95% CI 1.0-3.8).     

Determinants of neonatal mortality: a case-control study in Fortaleza, Ceará State, Brazil

This case-control study with 132 cases and 264 controls aimed to determine predictors of neonatal mortality using hierarchical modeling. Cases were defined as newborns that died within 28 days of birth, and controls as the survivors, among infants of mothers living in Fortaleza, Ceará State, Brazil. Hierarchical logistic regression identified factors associated with neonatal death: maternal race, with brown/black race showing a protective effect (OR = 0.23; IC95%: 0.09-0.56), time spent from home to the hospital > 30 minutes (OR = 3.12; 95%CI: 1.34-7.25), time < 1h or > 10 hours between hospital admission and delivery (OR = 2.43; 95%CI: 1.24-4.76), inadequate prenatal care (OR = 2.03; 95%CI: 1.03-3.99), low birth weight (OR = 14.75; 95%CI: 5.26-41.35), prematurity (OR = 3.41; 95%CI: 1.29-8.98), and male gender (OR = 2.09; 95%CI: 1.09-4.03). In this case series, neonatal deaths were associated with the quality of prenatal care and direct care during labor.     

Maternal, delivery, and perinatal characteristics associated with cryptorchidism: a population-based case-control study among births in Washington State

BACKGROUND: The etiology of cryptorchidism is largely unknown. To identify maternal, perinatal, and delivery characteristics associated with cryptorchidism at birth, we conducted a population-based case-control study using Washington State birth certificates linked to birth hospitalization records. METHODS: We identified 2,395 cases of cryptorchidism among male infants born in Washington State during 1986-1996, and, for comparison, we randomly selected four controls per case (N = 9,580), frequency-matched by year of birth. RESULTS: Infant characteristics associated with cryptorchidism included low birth weight (OR = 1.5; 95% CI = 1.3-1.8), small size for gestational age (OR = 1.9; 95% CI = 1.6-2.2), and breech presentation (OR = 1.7; 95% CI = 1.4-2.1). In addition to cryptorchidism, cases were more likely to have another type of congenital malformation (OR = 3.7; 95% CI = 3.2-4.2), particularly digestive (OR = 6.8; 95% CI = 3.7-12.7) or genitourinary (OR = 4.1; 95% CI = 3.0-5.6). Maternal and pregnancy characteristics associated with cryptorchidism included nulliparity (OR = 1.2; 95% CI = 1.1-1.3), maternal smoking during pregnancy (OR = 1.2; 95% CI = 1.1-1.4), and the following pregnancy complications: oligohydramnios (OR = 1.8; 95% CI = 1.3-2.6), placental abnormality (OR = 1.3; 95% CI = 1.0-1.8), and pregnancy-induced hypertension (OR = 1.6; 95% CI = 1.4-1.9). Odds ratios were similar when the analysis was restricted to term infants. CONCLUSIONS: These findings suggest that factors affecting fetal growth and development may increase the risk of cryptorchidism.     

Parental age and risk of childhood cancers: a population-based cohort study from Sweden

BACKGROUND: Frequent germ line cells mutations were previously demonstrated to be associated with aging. This suggests a higher incidence of childhood cancer among children of older parents. A population-based cohort study of parental ages and other prenatal risk factors for five main childhood cancers was performed with the use of a linkage between several national-based registries. METHODS: In total, about 4.3 million children with their parents, born between 1961 and 2000, were included in the study. Multivariate Poisson regression was used to obtain the incidence rate ratios (IRR) and 95% confidence interval (CI). Children <5 years of age and children 5-14 years of age were analysed independently. RESULTS: There was no significant result for children 5-14 years of age. For children <5 years of age, maternal age were associated with elevated risk of retinoblastoma (oldest age group's IRR = 2.39, 95%CI = 1.17-4.85) and leukaemia (oldest age group's IRR = 1.44, 95%CI = 1.01-2.05). Paternal age was significantly associated with leukaemia (oldest age group's IRR = 1.31, 95%CI = 1.04-1.66). For central nervous system cancer, the effect of paternal age was found to be significant (oldest age group's IRR = 1.69, 95%CI = 1.21-2.35) when maternal age was included in the analysis. CONCLUSION: Our findings indicate that advanced parental age might be associated with an increased risk of early childhood cancers.     

母亲孕前及分娩前超重肥胖对中学生超重肥胖影响的病例对照研究

目的 探讨广州市母亲孕前及分娩前超重肥胖对子代中学时期超重肥胖的影响,为预防中学生肥胖提供科学依据.方法 依托广州市中学生常规体检,抽取3所高中、3所初中共3384名学生,将体检中超重肥胖的中学生纳入超重肥胖组(642名),其余学生纳入对照组(2742名),对学生及家长进行问卷调查.使用倾向性评分匹配(propensi...     

Food insecurity and gender are risk factors for obesity

OBJECTIVE: Examine relationships between adult obesity, childhood overweight, and food insecurity. DESIGN: Cross-sectional retrospective study. SETTING: Community settings in Hartford, Connecticut. PARTICIPANTS: Convenience sample of 200 parents and their 212 children, aged 2-12. MAIN OUTCOME MEASURES: Adult obesity (Body Mass Index [BMI] > 30), childhood overweight (BMI-for-age > 95(th) percentile), and household food security (U.S. Department of Agriculture module). ANALYSIS: Chi-square tests between weight status and socioeconomic characteristics. Multinomial regression analyses to determine risk factors for adult obesity and childhood overweight. RESULTS: Over half of parents (51%) were obese, and almost one-third of children (31.6%) were overweight. Over half of households were food insecure. Food insecure adults were significantly more likely to be obese as those who were food secure (Odds Ratio [OR]=2.45, p = .02). Being a girl and having an obese parent doubled the likelihood of children being overweight (OR=2.56, P = .01; OR=2.32, P = .03). Children with family incomes below 100% of poverty were half as likely to be overweight as those with higher incomes (OR=.47, P = .05). Food insecurity did not increase odds of childhood overweight. CONCLUSIONS AND IMPLICATIONS: Obesity prevention programs and policies need to address food insecurity and gender as key risk factors.     

Perinatal and early life factors associated with symptoms of depression in Brazilian children

ABSTRACT: BACKGROUND: Few studies have been conducted on the association between perinatal and early life factors with childhood depression and results are conflicting. Our aim was to estimate the prevalence and perinatal and early life factors associated with symptoms of depression in children aged 7 to 11 years from two Brazilian birth cohorts. METHODS: The study was conducted on 1444 children whose data were collected at birth and at school age, in 1994 and 2004/2005 in Ribeirao Preto, where they were aged 10-11 years and in 1997/98 and 2005/06 in Sao Luis, where children were aged 7-9 years. Depressive symptoms were investigated with the Child Depression Inventory(CDI), categorized as yes (score greater than or equal to 20) and no (score<20). Adjusted and non-adjusted prevalence ratios (PR) were estimated by Poisson regression with robust estimation of the standard errors. RESULTS: The prevalence of depressive symptoms was 3.9% (95%CI=2.5-5.4) in Ribeirao Preto and 13.7% (95%CI=11.0-16.4) in Sao Luis. In the adjusted analysis, in Ribeirao Preto, low birth weight (PR=3.98; 95%CI=1.72-9.23), skilled and semi-skilled manual occupation (PR=5.30; 95%CI=1.14-24.76) and unskilled manual occupation and unemployment (PR=6.65; 95%CI=1.16-38.03) of the household head were risk factors for depressive symptoms. In Sao Luis, maternal schooling of 0-4 years (PR=2.39; 95%CI=1.31-4.34) and of 5 to 8 years (PR=1.80; 95%CI=1.08-3.01), and paternal age <20 years (PR=1.92; 95%CI=1.02-3.61), were independent risk factors for depressive symptoms. CONCLUSIONS: The prevalence of depressive symptoms was much higher in the less developed city, Sao Luis, than in the more developed city, Ribeirao Preto, and than those reported in several international studies. Low socioeconomic level was associated with depressive symptoms in both cohorts. Low paternal age was a risk factor for depressive symptoms in the less developed city, Sao Luis, whereas low birth weight was a risk factor for depressive symptoms in the more developed city, Ribeirao Preto.     

母亲童年期不良经历与学龄前儿童自闭症行为的关联

  目的  了解母亲童年期不良经历(adverse childhood experiences, ACEs)和学龄前儿童自闭症行为发生的相关性,为有效预防学龄前儿童自闭症发生提供依据。  方法  采用分层整群抽样方法,选取合肥市3 655名幼儿园儿童,了解儿童一般基本情况,采用童年期不良经历问卷(ACEs-IQ)和克氏自闭症行为量表(CABS)分别评估母亲ACEs和儿童自闭症行为情况。建立多因素Logistic回归模型,控制相关混杂因素,分析母亲ACEs对学龄前儿童自闭症行为的影响。  结果  学龄前儿童自闭症行为检出率为6.10%,男童(7.22%)高于女童(4.86%),差异有统计学意义(χ2=8.85,P < 0.01)。调整相关混杂因素后,母亲有ACEs组学龄前儿童自闭症行为的检出率高于母亲无ACEs组[OR值(95%CI)=2.77(1.92~3.99),P < 0.05]。母亲ACEs与学龄前男童、女童自闭症行为的风险增加相关,男童OR值(95%CI)=2.90(1.81~4.64),女童OR值(95%CI)=2.56(1.43~4.61)(P值均 < 0.05)。  结论  母亲ACEs暴露与学龄前儿童自闭症行为相关,降低学龄前儿童自闭症行为需要关注母亲ACEs的代际影响。