早产儿初中阶段行为问题研究

目的分析早产儿初中阶段行为问题的发生情况及其影响因素,以便采取相应的干预措施,提高早产儿青春期的心理健康水平。方法整群抽取蚌埠市1所重点中学、3所普通中学的初一和初二年级学生3559人,以Conners儿童行为问卷(父母问卷)调查并评定学生的行为问题,以自编的问卷调查早产儿父母的人口统计学变量、儿童出生情况(包括早产史)、母亲妊娠史等。共调查早产儿257名,足月产对照2903名,对两组行为问题的检出情况进行比较,并进行影响因素的单因素和多因素Logistic回归分析。结果早产儿在初中阶段品行问题和焦虑的检出率较足月产对照儿童高。单因素分析显示,影响儿童行为问题的因素有母亲职业、家庭类型、家庭气氛、教育子女方、父母教育子女态度、父母教育方式、母亲怀该儿童时的孕次、母亲孕期服用保胎药、儿童出生时窒息情况和儿童是否为独生子女。除儿童是否为独生子女外,其他因素均与对照组相似。多元Logistic回归分析显示,儿童出生时窒息和母亲孕期服用保胎药为行为问题产生的危险因素,母亲职业为教师、医务人员、技术人员、机关人员的和父母亲教育态度一致是早产儿童初中阶段行为问题的保护因素。结论早产会对初中阶段儿童的行为问题产生不利影响,需针对影响早产儿行为问题的因素早期采取干预措施,以减少早产儿青春期行为问题的发生。     

安徽省某农村地区儿童精神发育迟滞危险因素病例对照研究

目的 探讨农村地区儿童精神发育迟滞(Mental Retardation，MR)的危险因素。方法 对安徽省某乡镇的24个行政村所有常住家庭中4～17岁儿童进行人户调查，确诊75名无明确病因精神发育迟滞儿童作为病例组，按年龄、性别进行1：2的配比，在同一村选择智力正常且无其它缺陷的150名儿童作为对照组，对上述儿童进行智力测验、社会适应性能力评价及自制问卷调查。结果 单因素分析儿童MR的危险因素有：家庭贫困、母亲文化程度低、父母亲智力低下或癫痫家族史、母亲妊娠前月经周期异常、母孕期发热、母孕期出血、母孕期患有慢性病、早产、出生后第一声啼哭是否需辅助、新生儿发热、惊厥、窒息。COX比例风险模型分析儿童精神发育迟滞危险因素的结果显示，父母亲智力低下或癫痫家族史、母孕期是否患慢性病、是否早产、出生后第一声啼哭是否需辅助5个因素进入最终方程。结论 社会文化因素、遗传因素及围生期因素与儿童MR的发生相关，应采取综合的干预措施，减少儿童精神发育迟滞的发生。     

孕早期阴道出血对足月分娩婴儿发育影响的回顾性定群研究

目的:探讨孕早期阴道出血对足月分娩婴儿发育的影响。方法:分别以89名孕早期有阴道出血史的足月分娩婴儿的母亲为暴露组和155名在整个妊娠期间无阴道出血的足月分娩婴儿的母亲为对照组,用Bayley婴幼儿发展量表测试婴儿的智力发展指数和精神运动发展指数,用Carey婴儿气质问卷评定婴儿气质,并进行分析。结果:孕早期有出血史的孕妇所分娩的足月婴儿产前或出生时胎儿窘迫的发生率高于对照组,出生体重低于对照组,胎龄小于对照组,检查时精神运动发育指数低于对照组;智力发展指数、气质类型、体格发育情况两组差异无统计学意义。结论:孕早期阴道出血在足月分娩的婴儿中仍然是影响胎儿宫内发育的因素之一,且可能影响到其出生后的精神运动发育。     

韦克斯勒儿童智力量表（WISC—R）城市常模的制定及应用研究

本文采用经我国修订的WISC-R量表,对5032名6～16岁城市儿童少年进行了智力测验,制定了WISC-R河南省城市常模。运用微电脑对影响儿童智力的若干因素进行了多元回归分析。结果表明在智力上存在一定的性别差异,男生优于女生、独生子女优于非独生子女。多因素分析结果表明:智商与子女人数、父亲文化程度、母亲文化程度、语文成绩、数学成绩这5种因素呈线性关系。各因素中,以数学成绩对智商影响程度最大,其它依次为母亲文化程度、语文成绩、父亲文化程度、子女人数。     

杭州市余杭区家庭环境因素对儿童感觉统合情况影响分析

目的:研究感觉统合失调与家庭环境相关因素的关系。方法:采用感觉统合评定量表和自制家庭环境一般情况调查表分别对1 131例学龄前儿童进行检测、分析。结果:被调查的儿童感觉统合失调率为32.5%;父母亲文化程度与经济条件不同、家庭结构不同、婚姻关系状况、教养方式差异、是否寄养、是否为独生子女等儿童之间感觉统合失调情况差异有统计学意义(P0.05);并且母亲怀孕期间用药、妊娠严重呕吐、儿童在出生后发生过重大疾病与感觉统合失调发生情况也存在统计学差异。结论:儿童感觉统合失调与家庭环境因素有一定关系,改善家庭环境有利于降低儿童感觉统合失调发生率。     

学龄前儿童感觉统合与家庭环境影响因素相关研究

目的：研究感觉统合失调与家庭环境相关因素的关系。方法：采用感觉统合评定量表和自制家庭环境一般情况调查表量表分别对1131名学龄前儿童进行检测、分析。结果：感觉统合失调率32.54%;通过分析不同父母亲文化程度、经济条件、教养方式、是否为独生子女等儿童之间感觉统合失调情况有显著性差异（P〈0.05）。结论：儿童感觉统合失调与家庭环境因素有一定关系,改善家庭环境有利于降低儿童感统失调发生率。     

孕母影响婴儿智力因素的探讨

目的 观察来自母亲及胎儿的多种因素对新生婴儿智力发育的影响. 方法征集2007年5月-2008年6月期间在北京妇产医院产科进行全程产科检查并分娩的母亲及其止常新生婴儿346例作为调查研究对象.由儿科门诊医生对母亲进行回顾性问卷调查,内容包括:母亲妊娠年龄、职业、文化程度、分娩方式、孕期合并症、胎儿合并症等.同时由专门的医生对婴儿进行智力测评.用卡方检验、t榆验、相关分析对婴儿智力测评的结果与影响因素进行统计分析. 结果在所有346名健康婴儿中,5个方面智力测评的不及格率分别为:大运动39.9%、精细运动19.9%、适应能力21.4%、语言能力8.4%、社会行为能力4.0%.剖宫产的婴儿与自然分娩儿相比,语言能力有显著降低(P<0.01).母亲患有孕期合并症会显著降低婴儿的适应能力评分(P<0.01),胎儿孕期合并症会显著降低婴儿的大运动评分(P<0.01)和精细运动评分(P<0.05).母亲文化程度及分娩年龄对婴儿智力测评结果没有显著影响. 结论本次调查研究表明,剖宫产、孕母和胎儿的合并症是影响新生婴儿智力发育的主要因素.     

周口地区儿童少年智力测试情况调查分析

采用韦克斯勒儿童智力量表对周口地区６—１６岁中小学生８５８人进行智力测试,结果表明该区儿童少年平均智商为９９８８,智商分布近似正态分布。调查结果还提示了影响儿童智力发育的影响因素以数学成绩的影响因素程度较大,母亲文化程度、语文成绩、父亲文化程度、独生子女、非独生子女等诸多因素均有影响。     

幼儿气质的相关因素研究

【目的】　探讨影响幼儿气质的相关因素。　【方法】　对 2 3 4名合格对象采用PCR、VNTR多态性分析技术 ,检测其DRD4exonⅢ 48bpVNTR ;用TTS测查其气质 ;用家庭因素问卷了解其家庭环境因素。 　【结果】　幼儿气质类型与性别、父亲对子女不良行为采用说理的教育方法 ,父母亲生活规律、父亲性格随和、母乳喂养、产伤、脐带绕颈、出生体重有关 ;幼儿气质维度与性别、父亲 (或母亲 )对子女不良行为的处理方法、父母亲及带领人文化程度、父母离异、是否经常感冒、父母亲生活规律、DRD4exonⅢ 48bpVNTR等因素有关 ,影响注意力分散度的因素由强到弱依次是 :DRD4exonⅢ 48bpVNTR >母亲文化程度 >父亲生活规律。 　【结论】　幼儿气质受家庭环境和DRD4ex onⅢ 48bpVNTR的影响     

家庭环境对3~6岁儿童行为问题影响的研究

目的 调查太原市3~6岁儿童行为问题发生状况,分析家庭环境对其发生的影响,为减少儿童行为问题有针对性地采取干预措施。方法 采用Conners行为量表(CBCL)和自制家庭环境问卷对1 143名3~6岁儿童的行为及其家庭环境进行评估,并对调查结果进行统计分析。结果 单因素分析显示父母关系、父母文化程度、教育方式、父母对子女期望、是否留守儿童、亲子互动和看电视时间等这7个因素影响儿童行为发育。多元回归分析显示父母关系、亲子互动、父母对子女的期望、教育方式和留守儿童这5个家庭环境因素与儿童行为问题的发生密切相关。结论 3~6岁儿童行为问题不容忽视,要避免行为问题的发生,必须有效控制家庭环境中不利因素。     

陕西西部农村学龄早期儿童智力发育水平及其影响因素研究

目的了解陕西西部农村学龄早期儿童智力发育水平及影响因素,以期为提高该人群智力发育的政策制定提供参考依据。方法 2013-2014年采用现场询问的方法对前期参与"中国西部农村新生儿低出生体重的微营养素干预研究"项目的人群进行一对一上门随访其社会经济基本情况,采用《韦氏量表》对儿童智力进行评估。结果共调查儿童1 621人,年龄范围7~10岁。智力发育标化总分为89.9,男童(90.6)高于女童(88.8)。男童语言理解指数(89.5)和知觉推理指数(95.1)高于女童(86.0,90.5);女童工作记忆指数(97.5)高于男童(94.9)。影响儿童智力的因素包括:性别、家长学历、儿童学校、分娩方式等。结论陕西西部农村地区儿童学龄早期智力发育水平整体偏低。纠正性别观念和提升家长文化程度可消除该地区儿童智力发育性别差异并提高其整体智力水平。     

衡阳市7—13岁儿童智力水平及影响因素

为进一步探讨儿童的智力发育水平及影响因素，本文采用中国—韦氏儿童智力量表（Ｃ—ＷＩＳＣ）对衡阳市２３８名小学生进行了智力测验和相关因素分析，结果表明，智商发育水平整体较高，呈正态分布，言语智商高于操作智商。智商与入学实足年龄、母亲受教育程度、学习成绩，课外活动爱好密切相关     

Influence of breastfeeding on cognitive outcomes at age 6-8 years: follow-up of very low birth weight infants

The relation between breastfeeding and childhood cognitive development was examined in 1991-1993 among 439 school-age children weighing <1,500 g when born in the United States between 1991 and 1993. Measures of cognitive function included overall intellectual function, verbal ability, visual-spatial and visual-motor skill, and memory. Higher test scores for each domain of cognitive function except memory were observed among children who were breastfed directly. After covariate adjustment for home environment, maternal verbal ability, a composite measure of parental education and occupation, and length of hospitalization, the authors found that breastfed children evidenced an advantage only for measures specific to visual-motor integration (5.1 intelligence quotient (IQ) points, 95% confidence interval: 1.0, 9.2). Differences in test scores between breastfed children and those who did not receive any breast milk feedings were 3.6 IQ points (95% confidence interval: -0.3, 7.5) for overall intellectual functioning and 2.3 IQ points (95% confidence interval: -3.0, 7.6) for verbal ability. Indicators of social advantage confound the association between breastfeeding and cognitive function, but careful measurement can reduce residual confounding and may clarify causal relations.     

857名学童智力影响因素分析

目的研究影响儿童智力的主要环境因素。方法测定了857名小学1～6年级学生的智商,划分成4个等级;有关环境因素经问卷调直收集;采用有序结果logistic回归分析方法,对各因素逐一进行一元及多元回归分析。结果单因素分析显示27项因素差异有显著性;再经多因素逐步回归分析,父母文化程度、婴儿期喂养方式、幼时家教、3岁前营养、是否单亲家庭及平均学业成绩等6项因素作为重要变量进入了回归模型。结论儿童智力发育受到众多因素的影响,而良好的后天环境因素（尤其是早期营养、家庭背景及教育等）有利于促进儿童智力的发育,提高其智能水平。     

A dose-response relationship between maternal smoking during late pregnancy and adult intelligence in male offspring

An association between maternal smoking during pregnancy and cognitive and behavioural development has been observed in several studies, but potential effects of maternal smoking on offspring adult intelligence have not been investigated. The objective of the present study was to investigate a potential association between maternal smoking during pregnancy and offspring intelligence in young adulthood. Adult intelligence was assessed at the mean age of 18.7 years by a military draft board intelligence test (Borge Priens Prove) for 3044 singleton males from the Copenhagen Perinatal Cohort with information regarding maternal smoking during the third trimester coded into five categories (about 50% of the mothers were smokers). The following potential confounders were included as covariates in multivariable analyses: parental social status and education, single mother status, mother's height and age, number of pregnancies, and gestational age. In separate analyses, birthweight and length were also included as covariates. Maternal cigarette smoking during the third trimester, adjusted for the seven covariates, showed a negative association with offspring adult intelligence (P=0.0001). The mean difference between the no-smoking and the heaviest smoking category amounted to 0.41 standard deviation, corresponding to an IQ difference of 6.2 points [95% confidence interval 0.14, 0.68]. The association remained significant when further adjusted for birthweight and length (P=0.007). Both unadjusted and adjusted means suggested a dose-response relationship between maternal smoking during pregnancy and offspring adult intelligence. When subjects with missing data were excluded, essentially the same results were obtained in the reduced sample (n=1829). These results suggest that smoking during pregnancy may have long-term negative consequences on offspring adult intelligence.     

Stability and change in children's intelligence quotient scores: a comparison of two socioeconomically disparate communities

The authors estimated the influence of familial factors and community disadvantage on changes in children's intelligence quotient (IQ) scores from age 6 years to age 11 years. Data were obtained from a longitudinal study of the neuropsychiatric sequelae of low birth weight in two socioeconomically disparate, geographically defined communities in the Detroit, Michigan, metropolitan area. Representative samples of low birth weight and normal birth weight children from the City of Detroit (urban) and nearby middle-class suburbs (suburban) were assessed at age 6 years (in 1990-1992) and age 11 years (in 1995-1997) (n = 717). Children's IQs were measured using the Wechsler Intelligence Scale for Children-Revised. The familial factors considered included maternal IQ, education, and marital status. Multiple regression analysis applying generalized estimating equations was used. The IQs of urban children, regardless of birth weight, declined from age 6 years to age 11 years. The downward shift increased by 50% the proportion of urban children scoring 1 standard deviation below the standardized IQ mean of 100. A negligible change was observed in suburban children. Maternal IQ, education, and marital status and low birth weight predicted IQ at age 6 years but were unrelated to IQ change. Growing up in a racially segregated and disadvantaged community, more than individual and familial factors, may contribute to a decline in IQ score in the early school years.     

Maternal smoking during pregnancy and offspring IQ

BACKGROUND: Maternal smoking in pregnancy lowers birthweight. It is unclear, however, whether smoking during pregnancy lowers offspring IQ, and, if it does, whether it is through the smoking effect on fetal growth. METHOD: Representative samples of low birthweight (<2500 g) and normal birthweight children born in 1983-85 from inner-city and suburban communities in southeast Michigan, USA were assessed at ages 6, 11, and 17, using Wechsler intelligence tests. Smoking during pregnancy was ascertained from mothers at the first assessment; and smoking at any time was ascertained at the first and second assessment. Generalized estimating equation models were used, with children's IQ at all three assessments as outcomes (n = 798). RESULTS: Without adjustment, offspring of mothers who smoked during pregnancy scored 6.8 IQ points lower than offspring of mothers who never smoked, on average. Low birthweight children scored 5.4 IQ points lower than normal birthweight children, on average. The statistical association of maternal smoking with offspring IQ was confounded by maternal characteristics, chiefly, maternal cognitive ability as measured by IQ and education; adjustment for these factors eliminated the association. By contrast, adjustment for maternal IQ and education as well as smoking during pregnancy had a negligible effect on the low birthweight-related IQ deficit. Low birthweight did not mediate the association of smoking and lowered IQ in offspring. CONCLUSION: Maternal smoking during pregnancy is a proxy for a matrix of vulnerabilities for adverse child cognitive development and has no direct causal effect on child's IQ. The relationship of low birthweight and IQ is independent of maternal smoking and maternal cognitive abilities.     

中国城市地区0~5岁儿童养育实践相关因素分析

目的 了解我国城市地区0~5岁儿童养育实践情况及其影响因素,为促进我国儿童早期发展、开展父母积极养育指导和服务提供依据。方法 2017年8-12月在我国14省15个城市4 515名0~5岁的儿童家长中进行自填式问卷调查,采用父母养育与家庭适应量表（PAFAS）评价父母对儿童的养育实践情况,包括养育一致性、强迫性、鼓励性和亲子关系以及父母的情绪适应、家庭关系和相互协助等多个维度,通过单因素分析和多重线性回归探索儿童个体、父母和家庭因素对父母养育实践的影响。结果 我国城市地区0~5岁儿童的父母在PAFAS量表中的总得分为21.00（15.00~28.00）分,该得分的变化与儿童年龄、独生子女、分娩方式、父亲文化程度、家长育儿信心、家长情绪、家庭年收入、家庭结构以及寻求专业支持等因素有关,提示我国儿童养育实践情况存在较大差异并受多种因素影响。结论 我国城市地区0~5岁儿童养育实践整体情况良好,养育实践与儿童个体、父母和家庭环境等多种因素有关,关注多重因素的影响有利于提高父母养育技能的培训效果,更好地促进儿童早期发展。     

Risk for cognitive deficit in a population-based sample of U.S. children with autism spectrum disorders: variation by perinatal health factors

BackgroundFrom 30% to 60% of children with an autism spectrum disorder (ASD) have an IQ measure that falls in the intellectual disability (ID) range. It is not well studied whether, for children within this ASD subgroup, there is variation in the risk for low IQ based on a child's perinatal risk factors.Objective/HypothesesWe assessed whether preterm delivery and term small-for-gestational-age (tSGA) were associated with various measures of cognitive deficit among children with ASDs.MethodsA sample of 1129 singleton children born in 1994 and identified through school and health record review as having an ASD by age 8 years were selected from a U.S. population-based surveillance network. Mean IQ and dichotomous IQ outcomes indicating various levels of ID were examined according to whether a child was preterm (<37 weeks' gestation) or tSGA (term delivery and birth weight <10th percentile for gestational age of a U.S. referent). Results for the total sample and within race-ethnicity/maternal education strata were adjusted for child sex and ASD subtype classification.ResultsMean IQ was significantly (p < .05) lower in children delivered preterm (69.5) than term (74.5) and tSGA (69.3) than term appropriate-for gestational age (75.3). In stratified analyses, the preterm-IQ association was significant only among non-Hispanic white (NHW) children with maternal education at birth of high school or less; adjusted mean IQ was 8 points lower among those delivered preterm (65.4) than term (73.8). Term-SGA was associated with a significant 8-point deficit in adjusted mean IQ (75.5 vs. 83.8) in NHW children with maternal education greater than high school and a 6-point deficit that approached significance (68.4 vs. 74.5, p = 0.10) in NHW children with maternal education of high school or less. Non-Hispanic black children in both maternal education groups had significantly lower mean IQs than NHW children with little variation by preterm or tSGA.ConclusionsIn children with ASDs, the risk for concurrent ID or IQ deficit is associated with both preterm delivery and tSGA; these associations may vary by race-ethnicity and SES. Further studies of ASD-ID co-occurrence and the effectiveness of intervention strategies should consider both perinatal and sociodemographic factors.