24月龄幼儿心理行为预警征筛查现状及影响因素分析

目的 了解24月龄幼儿心理行为预警征筛查情况并分析可能的影响因素,为临床有效筛查提供参考。方法 在全国4个省的5个县区采用随机抽样的方法选取2016年内出生的2 731例婴儿作为研究对象,追踪随访收集孕产妇基本情况和幼儿基本情况、喂养情况、生长发育和健康情况。以国家预警征筛查表为工具对儿童进行心理行为发育迟缓筛查。结果 追踪随访到2岁幼儿心理行为预警征筛查阳性率为6.65%,在性别和地区间差异有统计学意义(P＜0.05)。单因素分析结果显示,母乳喂养至6月龄及以上、家庭居住环境、幼儿每天室外活动时间和每天与儿童互动玩耍时间差异有统计学意义(P＜0.05)。多因素Logistic回归分析结果显示,男童(OR=2.169,95%CI:1.516~3.103)、生活在北方(OR=2.308,95%CI:1.630~3.267)、母乳喂养未到6月龄(OR=1.645,95%CI:1.088~2.489)、幼儿每天在室外活动时间低于4 h(OR=2.715,95%CI:1.548~4.761)是2岁幼儿心理行为预警征筛查阳性的危险因素。结论 应注重幼儿早期心理行为预警征筛查,早发现、早转诊、早干预,提倡母乳喂养,家长在养育幼儿过程中要加强对幼儿的陪伴、多参加室外活动等,从而促进儿童健康成长。

Analysis of the status quo and influencing factors of early warning screening of psychological behavior in infants aged 24 months

Objective To know about the screening situation of early warning signs of psychological behavior in infants aged 24 months,and to explore the possible influencing factors,so as to provide reference for the effective screening in clinic. Methods A total of 2 731 infants born in 2016 were selected by random sampling in 5 counties across the 4 provinces in China,and the basic information of maternal and infants,feeding conditions,growth and health conditions were collected by follow-up survey.The national early warning sign screening table was used to screen children with mental behavior retardation. Results The positive screening rate of psychological behavior early warning signs in 2-year-old children was 6.65%,and significant differences existed between different gender and region groups(P<0.05).The results of single-factor analysis showed that there were significant differences on the positive rate of psychological behavior early warning signs among children with different breast-feeding duration,family living environment,outdoor activities and interaction time (P<0.05).Logistic regression analysis showed that boys (OR=2.169,95%CI:1.516―3.103),living in northern China (OR=2.308,95%CI:1.630―3.267),breastfeeding less than 6 months (OR=1.645,95%CI:1.088―2.489),and children′s outdoor activities less than 4 hours (OR=2.715,95% CI:1.548―4.761) were risk factors for the positive results of early warning screening in 2-year-old children. Conclusions It is suggested to pay more attention to early psychological behavior screening,early detection,early referral,early intervention in infants.In addition,parents are encouraged to promote breastfeeding,share more time to accompany infants and take part in outdoor activities,thereby facilitating the healthy growth of children.