母亲孕期参加孕妇学校与3岁儿童品行问题的关系

探讨孕妇孕期参加孕妇学校与3岁儿童品行问题的关系及其可能路径,为开展学龄前儿童身心健康研究提供基础资料.方法 以深圳市龙华区2014-2016年间新入园的40 237名3岁儿童为研究对象,调查内容包括一般人口学特征、母亲孕期参加孕妇学校情况,并使用Conners父母用症状量表评价品行问题.采用Cox回归探讨孕期参加孕妇学校与学龄前儿童品行问题的关系,并评价孕期被动吸烟、母乳喂养和孩子的户外活动在二者关系中的中介作用.结果 1 403(3.4%)名儿童品行问题得分高于临界值.不同性别、父母亲学历、家庭人均月收入、父母婚姻状况儿童品行问题异常发生率差异均有统计学意义(P值均<0.01).在控制儿童性别、父母学历、家庭收入、父母婚姻状况等混杂因素后,母亲孕期不参加孕妇学校与儿童3岁时的品行问题呈正相关(PRR=1.23,95%CI=1.11~1.37).母亲孕期被动吸烟、母乳喂养、0~3岁孩子户外活动情况分别在母亲孕期参加孕妇学校与儿童3岁时的品行问题中起中介作用,分别解释总变异的36.8%,3.0%和5.4%.结论 母亲孕期参加孕妇学校可降低儿童3岁时的品行问题,主要通过降低孕期母亲被动吸烟、增加母乳喂养和孩子户外活动实现.

Association of maternal pregnancy school attendances with conduct problems in 3-year-old preschool children

Objective To investigate the association between mothers' attendances to pregnancy school and conduct problems in 3-year-old preschool children as well as its potential pathway.Methods A total of 40 237 3-year-old children on their first entrance into kindergartens in the Longhua District,Shenzhen,China during 2014-2016 were selected as the research subjects.We used a general questionnaire to investigate information regarding the demographic characteristics and mother's attendances to pregnancy school,and the Conners' Parent Rating Scale to evaluate children's conduct problems.Cox regression was undertaken to investigate the association between mothers' attending pregnancy school and the offsprings' conduct problems.The stepwise mediation analysis put forward by Baron and Kenny was used to evaluate the mediating effect of passive smoking,breastfeeding and children's outdoor activities in the above association.Results A total of 1 403(3.4%) children scored high above the cut-off value in behavioral problems.After controlling for potential confounders including child gender,parent's education,family income,parent's marital status,etc.matemal pregnancy school absents were associated with higher risks of conduct related problems in their preschool children(PRR =1.23,95% CI =1.11-1.37).Results from further analysis showed that passive smoking during pregnancy,breast feeding,and outdoor activities during 0-3 year of child age mediated 36.8%,3.0% and 5.4% of the aforementioned association,respectively.Conclusion Mothers' prenatal attendances to the pregnancy school can reduce the risk of conduct related problems in 3-year-old children,mainly by reducing the passive smoking during pregnancy,increasing breastfeeding,and increasing children's outdoor activities.