性别与早产对通州区8~12月龄婴儿发育影响的交互作用研究

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摘要目的分析北京市通州区8~12月龄婴儿发育状况,探索婴儿发育状况的影响因素,重点探讨性别与早产因素对婴儿发育影响的交互作用。方法采用回顾性研究的方法,收集2013年1月1日至2017年12月31日在北京市通州区妇幼保健机构进行常规保健的8~12月龄婴儿发育的相关资料,采用丹佛发育筛查量表(中文版)进行婴儿发育评估,采用非条件Logistic回归模型探索婴儿发育的影响因素,采用相加和相乘交互作用模型探索性别和早产因素对婴儿发育的交互作用。结果 2013—2017年间共有42 583例8~12月龄婴儿进行DDST筛查,剔除“无法解释”的7例,DDST筛查可疑/异常比例为2.7%(1 161/42 576)。婴儿性别为男(调整OR:1.3,95%CI:1.2~1.5)、早产儿(调整OR:2.9,95%CI:2.2~3.8)、低出生体重儿(调整OR:2.3,95%CI:1.6~3.1)在调整了所有纳入单因素分析的变量后仍然是DDST筛查可疑/异常的独立预测因素。交互作用分析显示,婴儿性别为男和婴儿为早产儿对婴儿DDST筛查可疑/异常的交互作用的超额相对危险度(RERI)为1.2、交互作用归因比(AP)为21.1%、交互作用指数(S)为1.3,存在相加交互作用,但未发现相乘交互作用(OR=1.1,95%CI:0.7~1.6)。结论性别为男、早产和低出生体重是8~12月龄婴儿DDST筛查可疑/异常的重要危险因素,婴儿性别与早产因素对婴儿发育存在相加交互作用,没有发现相乘交互作用。未来,早产儿特别是早产男童的发育问题需要给予更多的关注。

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	冯保雯
	黄玥
	陈春屹
	曲雪琪
	刘美岑
	王银平
	梅楚楚
	周虹

关键词 ：发育, DDST, 婴儿, 性别, 早产, 交互作用

Abstract：Objective To analyze the developmental status of infants aged between 8 and 12 months in Tongzhou District of Beijing, to explore risk factors of developmental delay among the infants, and to examine the interaction effect between gender and preterm birth on the infant development.Methods A retrospective study was conducted through recruiting the infants aged between 8 and 12 months from Tongzhou Women and Children hospital in Beijing during Jan 1^st 2013 - Dec 31^st 2017, and collecting relevant variables from their medical records. The Denver Developmental Screening Test (DDST) (Chinese version) was used to evaluate the infant development. Univariate and multivariate logistic regression models were applied to analyze the risk factors of developmental delay. Additive and multiplicative models were utilized to explore the interaction effect between gender and preterm birth on infant development.Findings During 2013-2017, a total of 42,583 infants aged 8-12 months were screened by DDST and the prevalence of suspicious/abnormal outcome of DDST was 2.7% (1161/42,576). According to the logistic regressions, male infant (adjusted OR:1.3,95%CI:1.2-1.5), preterm birth (adjusted OR:2.9,95%CI:2.2-3.8) and low birth weight (adjusted OR:2.3,95%CI:1.6-3.1) were statistically significant predictors of suspicious/abnormal DDST result after adjusted for all the covariates included in the analysis. The effects on infant development of male infant and preterm birth were additively interacted, and the relative excess risk of interaction (RERI), attributable proportion (AP) and the interaction index (S) appeared as 1.2, 21.1% and 1.3, respectively. However, we didn′t observe the multiplicative interaction between male infant and preterm birth (OR=1.1,95%CI:0.7-1.6).Conclusion Male infant, preterm birth and low birth weight were important risk factors for suspicious/abnormal DDST result among infants aged 8-12 months. There was an additive interaction between gender and preterm birth, and no multiplicative interaction was found between the two factors. In future, more attention should be paid to the development of preterm infants, especially to the male preterm infants.

Key words： Development DDST Infants Gender Preterm birth Interaction

收稿日期: 2018-10-15

通讯作者: 周虹(hongzhou@bjmu.edu.cn)

引用本文:

冯保雯, 黄玥, 陈春屹, 曲雪琪, 刘美岑, 王银平, 梅楚楚, 周虹. 性别与早产对通州区8~12月龄婴儿发育影响的交互作用研究[J]. 中国生育健康杂志, 2020, 31(1): 5-9.
FENG Baowen, HUANG Yue, CHEN Chunyi, QU Xueqi, LIU Meicen, WANG Yinping, MEI Chuchu, ZHOU Hong. Interaction effect between gender and preterm birth on development of infants aged between 8 and 12 months in Tongzhou district of Beijing. Chinese Journal of Reproductive Health, 2020, 31(1): 5-9.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2020/V31/I1/5

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