0~3岁早产/低出生体重儿养育问题调查：一项多中心横断面研究

doi:10.12372/jcp.2024.23e1106

Abstract

Abstract:

Objective To understand the child-rearing problems and needs of premature/low birth weight (LBW) infants aged 0-3 years in urban areas of China, and to provide a basis for our child health clinicians to carry out targeted child-rearing guidance for high-risk infants. Methods Based on the child-rearing survey data of 1989 children aged 0-3 years and their parents from 15 cities in 14 provinces in China, the child-rearing problems faced by families with either premature/LBW infants or normal infants and their influencing factors were compared and analyzed. Results Among the 151 preterm/LBW infants surveyed in urban areas (7.6 %), 76.8 % of the parents of preterm/LBW infants had experienced at least 3 child-rearing problems in the past 3 months, higher than that of the normal group (66.8 %), and the difference was statistically significant (χ²=6.44, P=0.011). The main child-rearing problems of preterm/LBW infants were feeding or eating (67.6 %), sleep (66.2 %) and behavior (61.6 %). Multivariate logistic regression analysis showed that preterm/LBW infants were risk factors for child-rearing problems in families with infants and young children, and the occurrence of child-rearing problems of premature/LBW infants was related to children's gender, age, main caregivers, family structure and other factors. Conclusions Parents of premature/LBW infants generally have a higher risk of child-rearing problems, and there are specific problems in different age stages, so it is necessary to find child-rearing risk factors in time and provide targeted child-rearing counseling guidance for this group.

Key words: child-rearing problem, influence factor, premature infant, low birth weight infant

ZHAO Fenghua, ZHANG Yue, SUN Jin, YAN Shuangqin, LYU Lanqiu, MU Lijuan, YANG Jing, LUO Yan, YAN Dongmei, ZHAO Dongmei. Child-rearing problems of premature/low birth weight children aged 0 to 3 years: a multicenter cross-sectional study[J].Journal of Clinical Pediatrics, 2024, 42(7): 606-612.

Figures/Tables 5

References 37

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项目	早产/低出生体重儿组 (n=151)	正常组 (n=1 838)	χ²值	P
性别			0.39	0.531
男	80(53.0)	925(50.3)
女	71(47.0)	913(49.7)
年龄			4.07	0.131
0~1岁	57(37.7)	594(32.3)
1~2岁	56(37.1)	639(34.8)
2~3岁	38(25.2)	605(32.9)
分娩方式			19.96	<0.001
阴道分娩	61(40.4)	1 086(59.1)
剖宫产	90(59.6)	752(40.9)
母亲年龄			7.58	0.056
<25岁	9(6.0)	158(8.6)
25~30岁	60(39.7)	892(48.5)
30~35岁	46(30.5)	443(24.1)
≥35岁	36(23.8)	345(18.8)
主要照养人
母亲	113(74.8)	1 375(74.8)	0.00	0.995
父亲	47(31.1)	567(30.8)	0.01	0.944
外/祖父母	91(60.3)	1 057(57.5)	0.44	0.510
其他	9(6.0)	98(5.3)	0.11	0.742
独生子女	89(58.9)	1 288(70.1)	8.12	0.004
母亲文化程度			3.62	0.057
初中及以下	16(10.6)	120(6.5)
高中及以上	135(89.4)	1 718(93.5)
父亲文化程度			5.00	0.025
初中及以下	16(10.6)	110(6.0)
高中及以上	135(89.4)	1 728(94.0)
核心家庭	73(48.3)	857(46.6)	0.17	0.684
家庭年收入			2.72	0.473
<10万元	65(43.0)	677(36.8)
10~20万元	54(35.8)	694(37.8)
20~30万元	20(13.2)	275(15.0)
≥30万元	12(8.0)	192(10.4)

家庭养育问题	0~1岁(n=651)		χ²值	P	1~2岁(n=695)		χ²值	P
家庭养育问题	早产/低出生体重儿组 (n=57)	正常组 (n=594)	χ²值	P	早产/低出生体重儿组 (n=56)	正常组 (n=639)	χ²值	P
喂养或进餐	41(71.9)	317(53.4)	7.24	0.007	35(62.5)	388(60.7)	0.07	0.794
睡眠	45(79.0)	380(64.0)	5.15	0.023	31(55.4)	370(57.9)	0.14	0.712
语言发育	26(45.6)	181(30.5)	5.50	0.019	25(44.6)	291(45.5)	0.02	0.897
运动发育	28(49.1)	224(37.7)	2.86	0.091	15(26.8)	209(32.7)	0.83	0.363
行为	32(56.1)	296(49.8)	0.83	0.363	33(58.9)	367(57.4)	0.05	0.828
情绪	29(50.9)	280(47.1)	0.29	0.589	32(57.1)	343(53.7)	0.25	0.618
多子女照养	18(31.6)	164(27.6)	0.41	0.524	19(33.9)	169(26.5)	1.46	0.227
家庭养育问题	2~3岁(n=643)		χ²值	P	合计(n=1 989）		χ²值	P
家庭养育问题	早产/低出生体重儿组 (n=38)	正常组 (n=605)	χ²值	P	早产/低出生体重儿组 (n=151)	正常组 (n=1 838)	χ²值	P
喂养或进餐	26(68.4)	425(70.3)	0.06	0.811	102(67.6)	1 130(61.5)	2.18	0.140
睡眠	24(63.2)	326(53.9)	1.24	0.266	100(66.2)	1 076(58.5)	3.41	0.065
语言发育	23(60.5)	248(41.0)	5.60	0.018	74(49.0)	720(39.2)	5.63	0.018
运动发育	17(44.7)	156(25.8)	6.53	0.011	60(39.7)	589(32.1)	3.75	0.053
行为	28(73.7)	359(59.3)	3.07	0.080	93(61.6)	1 022(55.6)	2.03	0.154
情绪	23(60.5)	368(60.8)	0.00	0.971	84(55.6)	991(53.9)	0.17	0.685
多子女照养	12(31.6)	164(27.1)	0.36	0.549	49(32.5)	497(27.0)	2.05	0.152

家庭养育问题	偏回归系数	标准误	χ²值	P	OR(95%CI)
喂养或进餐	0.34	0.18	3.42	0.064	1.41(0.98~2.02)
睡眠	0.37	0.18	3.42	0.064	1.40(0.98~2.00)
语言发育	0.45	0.17	6.75	0.009	1.57(1.12~2.20)
运动发育	0.36	0.18	4.12	0.042	1.43(1.01~2.03)
行为	0.30	0.18	2.86	0.091	1.35(0.95~1.91)
情绪	0.12	0.17	0.46	0.497	1.13(0.08~1.58)
多子女照养	0.19	0.19	1.01	0.316	1.21(0.83~1.76)

影响因素	问题个数（≥3）	喂养或进餐	睡眠	语言发育	运动发育
影响因素	OR(95%CI)	OR(95%CI)	OR(95%CI)	OR(95%CI)	OR(95%CI)
儿童性别	3.53(1.42~8.73)	0.70(0.32~1.57)	1.48(0.70~3.13)	0.93(0.47~1.84)	1.33(0.65~2.68)
儿童年龄	1.13(0.62~2.04)	0.80(0.47~1.37)	0.60(0.36~0.99)	1.45(0.92~2.29)	0.83(0.52~1.31)
分娩方式	1.84(0.74~4.53)	1.11(0.49~2.51)	2.08(0.98~4.45)	1.02(0.51~2.07)	1.24(0.60~2.58)
母亲年龄	0.79(0.43~1.45)	1.13(0.66~1.94)	0.93(0.56~1.55)	0.97(0.61~1.54)	0.96(0.59~1.56)
妈妈为主要照养人	0.18(0.05~0.76)	1.00(0.36~2.79)	0.36(0.13~1.02)	0.67(0.28~1.63)	1.18(0.47~2.96)
爸爸为主要照养人	1.84(0.66~5.11)	2.31(0.91~5.88)	2.02(0.84~4.87)	1.33(0.63~2.82)	1.06(0.49~2.27)
外/祖父母为主要照养人	1.77(0.60~5.27)	4.61(1.58~13.45)	0.98(0.38~2.53)	0.65(0.28~1.49)	0.87(0.38~2.03)
独生子女	1.25(0.43~3.65)	1.43(0.55~3.72)	1.09(0.44~2.68)	1.08(0.47~2.50)	1.74(0.73~4.19)
母亲文化程度	0.64(0.08~5.22)	0.28(0.05~1.61)	0.70(0.14~3.50)	1.55(0.35~6.89)	0.26(0.05~1.28)
父亲文化程度	0.10(0.01~1.43)	0.48(0.08~2.81)	0.31(0.05~1.81)	0.32(0.07~1.49)	1.63(0.31~8.46)
核心家庭	4.09(1.44~11.63)	5.24(1.99~13.85)	2.08(0.91~4.77)	1.54(0.73~3.23)	1.80(0.83~3.90)
家庭年收入	1.50(0.85~2.64)	1.56(0.94~2.60)	1.24(0.80~1.93)	1.14(0.77~1.68)	1.25(0.83~1.87)
和专业人士探讨	1.36(0.45~4.06)	0.89(0.33~2.39)	1.37(0.54~3.45)	0.85(0.37~1.96)	1.15(0.49~2.69)
参加相关培训项目	0.74(0.22~2.51)	0.38(0.13~1.12)	0.58(0.21~1.57)	0.97(0.40~2.34)	0.64(0.26~1.60)

影响因素	行为	情绪	多子女照养
影响因素	OR(95%CI)	OR(95%CI)	OR(95%CI)
儿童性别	2.85(1.36~5.97)	1.79(0.89~3.59)	1.23(0.57~2.63)
儿童年龄	1.46(0.90~2.38)	1.08(0.69~1.71)	0.98(0.61~1.61)
分娩方式	1.16(0.55~2.45)	1.03(0.50~2.09)	1.44(0.66~3.17)
母亲年龄	0.90(0.54~1.50)	1.12(0.69~1.80)	1.06(0.65~1.75)
妈妈为主要照养人	0.46(0.17~1.24)	0.43(0.17~1.09)	0.46(0.17~1.24)
爸爸为主要照养人	2.22(0.97~5.08)	1.41(0.66~3.04)	1.07(0.47~2.44)
外/祖父母为主要照养人	1.25(0.51~3.03)	1.04(0.45~2.40)	0.59(0.23~1.50)
独生子女	0.92(0.37~2.30)	1.61(0.69~3.77)	0.59(0.24~1.46)
母亲文化程度	0.54(0.10~2.89)	0.55(0.12~2.54)	1.27(0.26~6.27)
父亲文化程度	1.39(0.26~7.31)	1.10(0.24~5.11)	0.50(0.10~2.62)
核心家庭	1.61(0.72~3.61)	1.56(0.73~3.35)	2.77(1.20~6.42)
家庭年收入	1.08(0.70~1.65)	0.87(0.59~1.30)	1.10(0.72~1.68)
和专业人士探讨	0.57(0.23~1.38)	1.46(0.62~3.41)	2.13(0.84~5.43)
参加相关培训项目	1.25(0.48~3.22)	1.09(0.44~2.70)	0.64(0.24~1.70)

Child-rearing problems of premature/low birth weight children aged 0 to 3 years: a multicenter cross-sectional study

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