12~36月龄幼儿胃肠道功能情况及其影响因素研究

目的描述12~36月龄幼儿胃肠道功能情况,探讨潜在影响因素。方法2018年9月—2019年1月在北京市朝阳区某社区卫生服务中心招募12~36月龄幼儿385名,收集幼儿及母亲基本信息,采用简版《婴幼儿胃肠道症状问卷》评估幼儿胃肠道功能。问卷共10个问题,反映幼儿胃肠道症状(6个问题)和相关行为(4个问题)。胃肠道功能总评分为10~60分,其中胃肠道症状6~36分、胃肠道相关行为4~24分,评分越高提示胃肠功能越弱;将总评分等于或高于第二个三分位数(17分)定义为轻度胃肠不适。采用多因素logistic回归分析幼儿轻度胃肠不适的可能影响因素。结果幼儿胃肠道功能总评分、症状评分和相关行为评分的中位数(四分位数间距)分别为13.0(11.0~19.0)分、6.0(6.0~10.0)分和6.0(5.0~8.0)分。小月龄(12~17月龄14.5分,18~23月龄13.0分)比大月龄(24~29月龄12.0分,30~36月龄12.5分)、母亲为初产妇(14.0分)比经产妇(12.0分)的幼儿中位胃肠道功能总评分高(P<0.05)。轻度胃肠不适幼儿124名(32.2%),母亲为初产妇(36.8%)比母亲为经产妇(21.8%)的幼儿轻度胃肠不适发生率显著升高(P=0.004)。多因素logistic回归分析显示,12~17月龄幼儿与30~36月龄幼儿相比(调整OR,2.32;95%CI,1.14~4.71)、母亲为初产妇的幼儿与经产妇的幼儿相比(调整OR,2.05;95%CI,1.19~3.52),轻度胃肠不适风险显著升高。幼儿性别、分娩方式、母乳喂养时长和母亲分娩年龄对轻度胃肠不适发生风险无显著影响。结论幼儿胃肠道功能整体较好,幼儿月龄及母亲产次影响幼儿胃肠功能,小月龄及母亲为初产妇的幼儿易发生轻度胃肠不适。

Analysis of gastrointestinal function in toddlers aged 12-36 months and its influencing factors

Objective To describe the gastrointestinal function among toddlers(12-36 months)and explore its potential influencing factors.Methods A total of 385 toddlers aged 12-36 months were recruited from September 2018 and January 2019 in a community health service center in Chaoyang District,Beijing.Characteristics of toddlers and their mothers were collected,and the gastrointestinal function of toddlers was evaluated using a simplified Infant Gastrointestinal Symptom Questionnaire(IGSQ).The questionnaire included 10 questions which reflected gastrointestinal symptoms(6 questions)and related behaviors(4 questions).The total score of gastrointestinal function ranged from 10 to 60,among which symptom score ranged from 6 to 36 and related behavior score ranged from 4 to 24.The higher the score indicated that the worse the gastrointestinal function was,and the total score equal to or higher than the second tertiles(score=17)was defined as mild gastrointestinal discomfort.Multivariate logistic regression was used to analyze the potential influencing factors of mild gastrointestinal discomfort.Results The medians(interquartile ranges)of total gastrointestinal function score,symptom score and related behavior score were 13.0(11.0-19.0),6.0(6.0-10.0)and 6.0(5.0-8.0),respectively.The median score of total gastrointestinal function score was significantly higher in younger(14.5 among toddles aged 12-17 months,13.0 among toddles aged 18-23 months)than older toddlers(12.5 among toddles aged 24-29 months,12.0 among toddles aged 30-36 months),and higher in toddlers delivered by primipara(14.0)than in those by multipara(12.0)(P<0.05).Among the 385 toddlers,124(32.2%)had mild gastrointestinal discomfort.The incidence of mild gastrointestinal discomfort was significantly higher in toddlers delivered by primipara(36.8%)than in those by multipara(21.8%)(P=0.004).The multivariate logistic regression analyses showed that the risk of mild gastrointestinal discomfort was significantly higher in toddlers aged 12-17 months compared to those aged 30-36 months(adjusted OR,2.32;95%CI,1.14-4.71),and in toddlers delivered by primipara compared to those by multipara(adjusted OR,2.05;95%CI,1.19-3.52).The risk of mild gastrointestinal discomfort was not significantly affected by sex,delivery mode,duration of breastfeeding and maternal age at delivery.Conclusion Toddlers in our study had a generally good gastrointestinal function.Age of toddlers and maternal parity might influence gastrointestinal function.Younger toddlers and those delivered by primipara mother had a higher risk of mild gastrointestinal discomfort.