养育环境与儿童早期发展的相关性

来源 :中华儿科杂志 | 被引量 : 0次 | 上传用户:jinmeng79
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目的:探讨儿童养育环境的影响因素及其与儿童早期发展的相关性。方法:采用分层整群随机抽样方法,于2017年在上海16个区抽取187所幼儿园共22 509名新入园儿童,对其家长进行问卷调查。采用育儿环境指数(ICCE)评估儿童家庭养育环境,采用人类早期能力指数了解儿童早期发展情况。根据ICCE分数在人群中的分布将被调查儿童分为4组,家庭养育环境最差组(≤10分)、中下组(11分)、中上组(12分)、最好组(13分)。分别使用线性回归模型和Logistic回归模型分析影响养育环境的相关因素以及养育环境对儿童早期发展的影响。结果:共22 067名儿童完成本次调查, 年龄(44±7)月龄, 男11 425名(51.8%),女10 642名(48.2%)。多元线性回归分析结果显示,女孩、母亲教育程度高、家庭年收入高、独生子女、父母非离异及早期母乳喂养经历是新入园学龄前儿童家庭养育环境的保护因素[n β=0.064、0.238、0.119、0.096、0.113、0.032,95%可信区间(n CI): 0.020~0.108、0.175~0.302、0.058~0.180、0.046~0.146、-0.012~0.242、-0.051~0.116,均n P<0.01]。多因素Logistic回归分析显示,相较于养育环境最好组,养育环境中上组、中下组和最差组早期发展高危风险均更高,n OR值分别为1.543 (95%n CI: 1.373~1.735, n P<0.01),2.537 (95%n CI: 2.254~2.856, n P<0.01)和4.198 (95%n CI: 3.757~4.690, n P<0.01)。n 结论:养育环境不仅与家庭结构及社会经济因素有关,且与早期母乳喂养经历显著相关。而良好的家庭养育环境对儿童早期发展促进具有重要的意义。“,”Objective:To investigate the factors related to child care environment and the association between child care environment and children′s early development.Methods:Using stratified cluster random sampling, a total of 22 509 children newly enrolled to kindergarten from 187 kindergartens of 16 districts in Shanghai in 2017 were enrolled. A survey was conducted by parent-reported questionnaire. The index of child care environment (ICCE) and the early human capacity index were used to evaluate family child care environment and children′s early development respectively. The sample was divided into four groups based on the ICCE score: the lowest family childcare environment (ICCE≤10 scores), lower middle (ICCE=11 scores), upper middle (ICCE=12 scores), and the highest (ICCE=13 scores). The linear regression model and Logistic regression model were used to analyze the factors related to child care environment and the association between child care environment and children′s early development respectively.Results:A total of 22 067 children aged (44±7) months, including 11 425 boys (51.8%) and 10 642 girls (48.2%), participated in this study. The multnomial linear regression revealed girls, higher maternal education, higher household annual income, single-child, non-divorced parents, and early breastfeeding experience were protective factors of child care environment for children newly enrolled to kindergarten (n β=0.064, 0.238, 0.119, 0.096, 0.113, and 0.032; 95% confidence interval (n CI): 0.020-0.108, 0.175-0.302, 0.058-0.180, 0.046-0.146, -0.012-0.242, and -0.051-0.116; all n P<0.01). The multinomial Logistic regression revealed compared with the highest child care environment group, the odds ratio of children′s early development risks in upper midclle, lower middle, and the lowest child care environment groups were 1.543 (95%n CI: 1.373-1.735, n P<0.01), 2.537 (95%n CI: 2.254-2.856, n P<0.01), and 4.198 (95%n CI: 3.757-4.690, n P<0.01), respectively.n Conclusions:The child care environment is not only significantly related to family structure and socioeconomic status, but also to early breastfeeding experience. The child care environment plays an important role in promoting childhood early development.
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