| 童年期不良经历与青春期发育的前瞻性研究 |
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| 引用本文： | 张雷,严双琴,汪素美,张丹丹,段晓楠,方姣,万宇辉,陶芳标,孙莹.童年期不良经历与青春期发育的前瞻性研究[J].中国学校卫生,2019,40(5):662-665,668. |
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| 作者姓名： | 张雷 严双琴 汪素美 张丹丹 段晓楠 方姣 万宇辉 陶芳标 孙莹 |
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| 作者单位： | 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系,合肥230032 |
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| 基金项目： | 国家自然科学基金(81872638) |
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| 摘 要： | 目的探讨童年期不良经历对青春期发育的影响,为针对性开展早期干预提供参考。方法于2017年10月在安徽省马鞍山市3所小学,采用整群抽样的方法以班级为单位抽取1 057名三至四年级学生为调查对象,自我报告童年期不良经历(adverse childhood experiences,ACEs),包括躯体、情感与性虐待和躯体、情感忽视。客观评估男生睾丸容积和女生乳房Tanner发育分期。1年后随访再次评价ACEs与青春期发育。根据儿童基线与随访暴露情况,将ACEs分为无暴露组、短暂暴露组和持续暴露组。采用多元线性回归模型分析各组ACEs与随访1年后青春期发育的关联。结果持续情感虐待与女生乳房Tanner分期和男生睾丸容积均呈正相关(β值分别为0.36,1.07,95%CI值分别为0.09～0.63, 0.47～1.66,P值均<0.01);持续躯体虐待与男生睾丸容积呈负相关(β=-0.83,95%CI=-1.58～-0.08,P<0.05);性虐待与女生乳房Tanner分期呈负相关(持续β=-1.43,95%CI=-2.86～-0.02;短暂β=-0.45,95%CI=-0.73～-0.19,P值均<0.05);持续情感忽视与女生乳房Tanner分期呈正相关(β=0.33,95%CI=0.06～0.61,P<0.05),与男生睾丸容积呈负相关(β=-0.19,95%CI=-1.38～-0.09,P<0.01)。结论青春期发育与童年期不良经历相关。不同ACEs青春期发育效应差异的具体机制和相同ACEs青春期发育效应的性别差异仍需进一步探讨。
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| 关 键 词： | 青春期发育 前瞻性研究 学生 |
Prospective association between adverse childhood experiences and pubertal development |
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| ZHANG Lei,YAN Shuangqin,WANG Sumei,ZHANG Dandan,DUAN Xiaonan,FANG Jiao,WAN Yuhui,TAO Fangbiao,SUN Ying.Prospective association between adverse childhood experiences and pubertal development[J].Chinese Journal of School Health,2019,40(5):662-665,668. |
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| Authors: | ZHANG Lei YAN Shuangqin WANG Sumei ZHANG Dandan DUAN Xiaonan FANG Jiao WAN Yuhui TAO Fangbiao SUN Ying |
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| Affiliation: | (Department of Maternal,Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China) |
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| Abstract: | Objective To explore the impact of adverse childhood experiences on pubertal development,and to provide a reference for conducting the targeted intervention in the early stage. Methods A cluster sampling method was used to randomly select students of grades 3 to 4 from three primary schools in Ma’anshan municipality of Anhui province in October 2017. Self-reported childhood adverse experiences(ACEs), including physical, emotional and sexual abuse, as well as physical and emotional neglect were collected. Testicular volume and breast Tanner stage were assessed. A follow-up survey was conducted one year later to assess ACEs and pubertal development. ACEs of each dimension were divided into non-exposure group, transient exposure group and sustained exposure group according to ACEs exposure at baseline and follow-up. Multivariate linear regression model was used to analyze the relationship between ACEs exposure and pubertal development after 1-year follow-up. Results Sustained emotional abuse was positively associated with increased breast Tanner stage and testicular volume(breast:β=0.36, 95%CI=0.09-0.63, P<0.01;testicular volume:β=1.07, 95%CI=0.47-1.66, P<0.01);sustained physical abuse was positively associated with decreased testicular volume(β=-0.83, 95%CI=-1.58--0.08, P<0.05);sustained and transient sexual abuse were significant positively associated with decreased breast Tanner stages(sustained:β=-1.43, 95%CI=-2.86--0.02, P<0.05;transient:β=-0.45, 95%CI=-0.73--0.19, P<0.05);sustained emotional neglect was positively associated with increased breast Tanner staging(β=0.33, 95%CI=0.06-0.61, P<0.05) and decreased testicular volume(β=-0.19, 95%CI=-1.38--0.19, P<0.01). Conclusion Sustained emotional abuse was associated with early pubertal development in boys and girls,and the specitic mechanisam differences of different ACES puberty development effects and the gender differences of the same ACES puberty development effects need to be furthur explored. |
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| Keywords: | Adolescent development Prospective studies Students |
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