安徽省某农村地区儿童精神发育迟滞危险因素病例对照研究

目的 探讨农村地区儿童精神发育迟滞(Mental Retardation，MR)的危险因素。方法 对安徽省某乡镇的24个行政村所有常住家庭中4～17岁儿童进行人户调查，确诊75名无明确病因精神发育迟滞儿童作为病例组，按年龄、性别进行1：2的配比，在同一村选择智力正常且无其它缺陷的150名儿童作为对照组，对上述儿童进行智力测验、社会适应性能力评价及自制问卷调查。结果 单因素分析儿童MR的危险因素有：家庭贫困、母亲文化程度低、父母亲智力低下或癫痫家族史、母亲妊娠前月经周期异常、母孕期发热、母孕期出血、母孕期患有慢性病、早产、出生后第一声啼哭是否需辅助、新生儿发热、惊厥、窒息。COX比例风险模型分析儿童精神发育迟滞危险因素的结果显示，父母亲智力低下或癫痫家族史、母孕期是否患慢性病、是否早产、出生后第一声啼哭是否需辅助5个因素进入最终方程。结论 社会文化因素、遗传因素及围生期因素与儿童MR的发生相关，应采取综合的干预措施，减少儿童精神发育迟滞的发生。

Case- control Study on Mental Retardation Risk Factors of Rural Area 4 ～ 17 - Year-old Population in Anhui Province

Objective To explore the risk factors of children mental retardation in the rural area. Methods In a town includes total 24 villages, we screened all suspected children and adolescents aged from 4 to 17 years old on intelligence by interview survey; and 75 children who were detected as MR without defined etiology consisted the patient group. Through a 1:2 matching by age and sex, 150 children who had normal intelligence and without birth defect were consisted as the control group. Both groups were tested on intelligence by WISC, social adaptation and investigated by questionnaire. Results By univariate analysis 11 risk factors were explored: family poverty, low culture level of mother, history of family on MR or epilepsy in parents, abnormal maternal menstrual cycle before pregnancy, febrile illess during gestation, bleeding in gestation period, chronic disease in gestation period, premature birth, assisted first crying after birth, neonatal febrile illness, convulsion and asphyxiation. By COX regression analysis, the results revealed 5 factors: which included the MR in parents, history of family on MR or epilepsy in parents, chronic disease in gestation period, premature birth and assisted first crying after birth entered the last regression model. Conclusions Risk factors of mental retardation are associated with social-cultural economic status, genetic factors and perinatal environmental factors. It is essential to take comprehensive measures to protect children from mental retardation.