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妊娠相关焦虑对学龄前儿童执行功能的影响及性别差异

谢晶晶 王晓旭 严双琴 徐叶清 朱鹏 郝加虎 陶芳标 黄锟

谢晶晶, 王晓旭, 严双琴, 徐叶清, 朱鹏, 郝加虎, 陶芳标, 黄锟. 妊娠相关焦虑对学龄前儿童执行功能的影响及性别差异[J]. 中国学校卫生, 2021, 42(9): 1359-1363. doi: 10.16835/j.cnki.1000-9817.2021.09.020
引用本文: 谢晶晶, 王晓旭, 严双琴, 徐叶清, 朱鹏, 郝加虎, 陶芳标, 黄锟. 妊娠相关焦虑对学龄前儿童执行功能的影响及性别差异[J]. 中国学校卫生, 2021, 42(9): 1359-1363. doi: 10.16835/j.cnki.1000-9817.2021.09.020
XIE Jingjing, WANG Xiaoxu, YAN Shuangqin, XU Yeqing, ZHU Peng, HAO Jiahu, TAO Fangbiao, HUANG Kun. Effect of pregnancy-related anxiety on executive function of preschool children and gender difference[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(9): 1359-1363. doi: 10.16835/j.cnki.1000-9817.2021.09.020
Citation: XIE Jingjing, WANG Xiaoxu, YAN Shuangqin, XU Yeqing, ZHU Peng, HAO Jiahu, TAO Fangbiao, HUANG Kun. Effect of pregnancy-related anxiety on executive function of preschool children and gender difference[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(9): 1359-1363. doi: 10.16835/j.cnki.1000-9817.2021.09.020

妊娠相关焦虑对学龄前儿童执行功能的影响及性别差异

doi: 10.16835/j.cnki.1000-9817.2021.09.020
基金项目: 

国家重点研发计划 2016YFC1000204-2

国家自然科学基金 81872630

科技部科技基础资源调查专项 2017FY101107

详细信息
    作者简介:

    谢晶晶(1995-),女,安徽阜阳人,在读硕士,主要研究方向为环境优生

    通讯作者:

    黄锟,E-mail: ahmuhaungk@163.com

  • 中图分类号: G 444 B 844.1

Effect of pregnancy-related anxiety on executive function of preschool children and gender difference

  • 摘要:   目的  探讨母体妊娠相关焦虑对子代学龄前执行功能(EFs)的影响及性别差异,以期针对性优化子代生命早期发育环境。  方法  选取中国安徽出生队列2008年10月—2010年10月在安徽省马鞍山市妇幼保健院孕早期建卡的孕妇,收集孕妇一般情况和妊娠相关焦虑情况。对队列内的3 556名3~5岁儿童进行随访,收集儿童相关特征,采用《学龄前儿童执行功能评定量表》(父母版)评价其执行功能。  结果  与对照组相比,仅孕早期存在妊娠相关焦虑与学龄前男童工作记忆、计划/组织功能和总执行功能(GEC)异常风险有关[OR 值(95%CI)分别为 1.40(1.06~1.85),1.64(1.06~2.54),1.89(1.27~2.82)];孕早、晚期同时存在妊娠相关焦虑与学龄前男童抑制、工作记忆、计划/组织功能和 GEC 异常风险有关[ OR值(95%CI)分别为 2.60(1.45~4.67),2.45(1.69~3.57),2.23(1.28~3.88),3.27(2.03~5.28)]。 仅孕早期存在妊娠相关焦虑与学龄前女童抑制和工作记忆异常有关[OR 值(95%CI)分别为 1.79(1.13~2.83),1.45(1.07~1.98)];仅孕晚期存在妊娠相关焦虑与学龄前女童抑制功能异常有关[OR 值(95%CI)= 2.26(1.17~4.38)];孕早、晚期同时存在妊娠相关焦虑与学龄前女童抑制和工作记忆功能异常风险有关[OR 值(95%CI)分别为 2.45(1.40~4.28),2.02(1.35~3.01)]。  结论  妊娠相关焦虑显著影响子代学龄前儿童执行功能,并存在剂量反应关系。妊娠相关焦虑在男童中主要影响工作记忆、计划/组织功能和总执行功能,在女童主要影响其工作记忆和抑制功能。
  • 表  1  母亲和儿童基本情况男女童分布特征

    Table  1.   Distribution of mothers and children

    变量 选项 男童(n=1 915) 女童(n=1 641)
    家庭人均月收入/元a < 2 000 1 071(55.9) 981(59.8)
    2 000~3 999 696(36.3) 541(33.0)
    ≥4 000 142(7.4) 118(7.2)
    母亲孕早期居住地a 农村 235(12.3) 200(12.2)
    城市 1 675(87.5) 1 440(87.8)
    不良孕产史a 930(48.6) 777(47.3)
    984(51.4) 864(52.7)
    妊娠合并症a 278(14.5) 233(14.2)
    1 619(84.5) 1 396(85.1)
    分娩方式 自然分娩 629(32.8) 559(34.1)
    剖宫产 1 286(67.2) 1 082(65.9)
    产次a 初产妇 1 806(94.3) 1 569(95.6)
    经产妇 108(5.6) 71(4.3)
    孕周/周a < 37 63(3.3) 57(3.5)
    37~38 493(25.7) 369(22.5)
    39~40 1 166(60.9) 1 011(61.6)
    ≥41 179(9.3) 195(11.9)
    4个月内喂养方式a 纯母乳 680(35.5) 624(38.0)
    非纯母乳 1 194(62.3) 981(59.8)
    3岁前父母带养 高比例 831(43.4) 747(45.5)
    非高比例 1 084(56.6) 894(54.5)
    近半年儿童主要居住地 市区 1 708(89.2) 1 456(88.7)
    非市区 207(10.8) 185(11.3)
    注:()内数字为构成比;a表示有缺失值。
    下载: 导出CSV

    表  2  不同性别儿童母亲不同妊娠相关焦虑下执行功能异常检出率比较

    Table  2.   Comparison of relevance ratio of abnormal executive function in different pregnancy-related anxiety among mothers of different sex children

    儿童性别 母亲焦虑分组 人数 统计值 抑制 转换 情绪控制 工作记忆 计划/组织 总执行功能
    孕早期 322 24(7.5) 8(2.5) 14(4.3) 93(28.9) 34(10.6) 42(13.0)
    孕晚期 121 8(6.6) 3(2.5) 5(4.1) 29(24.0) 11(9.1) 13(10.7)
    孕早期和孕晚期 136 16(11.8) 5(3.7) 8(5.9) 58(42.6) 18(13.2) 29(21.3)
    对照组 1 336 67(5.0) 22(1.6) 46(3.4) 288(21.6) 81(6.1) 96(7.2)
    χ2 11.59 3.35 2.37 33.88 15.17 35.67
    P < 0.01 0.34 0.50 < 0.01 0.00 < 0.01
    孕早期 304 34(11.2) 18(5.9) 4(1.3) 83(27.3) 18(5.9) 30(9.9)
    孕晚期 103 12(11.7) 5(4.9) 1(1.0) 25(24.3) 5(4.9) 9(8.7)
    孕早期和孕晚期 137 19(13.9) 8(5.8) 3(2.2) 43(31.4) 5(3.6) 13(9.5)
    对照组 1 097 67(6.1) 49(4.5) 11(1.0) 204(18.6) 36(3.3) 72(6.6)
    χ2 29.53 4.14 2.66 41.40 8.59 11.07
    P < 0.01 0.25 0.45 < 0.01 0.04 0.01
    注:()内数字为检出率/%
    下载: 导出CSV

    表  3  母亲妊娠相关焦虑与学龄前男童执行功能关联的Logistic回归分析[n = 1 915, OR 值(OR 值 95%CI)]

    Table  3.   Logistic regression analysis between mother's pregnancy-related anxiety and executive function in preschool boys[n = 1 915, OR(OR 95%CI)]

    母亲焦虑组别 模型 抑制 转换 情绪控制 工作记忆 计划/组织 总执行功能
    孕早期 模型1 1.53(0.94~2.47) 1.52(0.67~3.45) 1.28(0.69~2.35) 1.47(1.12~1.94)* 1.83(1.20~2.79)* 1.94(1.32~2.85)*
    模型2 1.51(0.92~2.48) 1.13(0.45~2.87) 1.25(0.66~2.34) 1.40(1.06~1.85)* 1.64(1.06~2.54)* 1.89(1.27~2.82)*
    孕晚期 模型1 1.34(0.63~2.86) 1.52(0.45~5.15) 1.21(0.47~3.10) 1.15(0.74~1.78) 1.55(0.80~3.00) 1.56(0.84~2.87)
    模型2 1.48(0.69~3.17) 1.52(0.45~5.16) 1.25(0.49~3.22) 1.15(0.74~1.79) 1.52(0.78~2.97) 1.67(0.90~3.10)
    孕早期和孕晚期 模型1 2.53(1.42~4.50)* 2.28(0.85~6.12) 1.75(0.81~3.80) 2.71(1.88~3.89)* 2.36(1.37~4.07)* 3.50(2.21~5.55)*
    模型2 2.60(1.45~4.67)* 1.96(0.66~5.78) 1.86(0.86~4.03) 2.45(1.69~3.57)* 2.23(1.28~3.88)* 3.27(2.03~5.28)*
    注:*P < 0.05。
    下载: 导出CSV

    表  4  母亲妊娠相关焦虑与学龄前女童的执行功能关联的Logistic回归分析[n = 1 641, OR 值(OR 值 95%CI)]

    Table  4.   Logistic regression analysis between mother's pregnancy-related anxiety and executive function in preschool girls[n = 1 641, OR(OR 95%CI)]

    母亲焦虑组别 模型 抑制 转换 情绪控制 工作记忆 计划/组织 总执行功能
    孕早期 模型1 1.94(1.25~2.99)* 1.35(0.77~2.35) 1.32(0.42~4.16) 1.65(1.22~2.21)* 1.86(1.04~3.32)* 1.56(0.99~2.44)
    模型2 1.79(1.13~2.83)* 1.21(0.68~2.16) 1.35(0.43~4.27) 1.45(1.07~1.98)* 1.44(0.77~2.71) 1.42(0.89~2.27)
    孕晚期 模型1 2.03(1.06~3.89)* 1.09(0.43~2.80) 0.97(0.12~7.57) 1.40(0.87~2.26) 1.50(0.58~3.92) 1.36(0.66~2.81)
    模型2 2.26(1.17~4.38)* 1.14(0.44~2.97) 0.98(0.13~7.65) 1.35(0.82~2.21) 1.74(0.66~4.63) 1.46(0.70~3.06)
    孕早期和孕晚期 模型1 2.48(1.44~4.26)* 1.33(0.61~2.86) 2.21(0.61~8.02) 2.00(1.35~2.96)* 1.12(0.43~2.90) 1.49(0.80~2.77)
    模型2 2.45(1.40~4.28)* 1.41(0.65~3.10) 2.18(0.60~7.91) 2.02(1.35~3.01)* 1.01(0.38~2.67) 1.52(0.81~2.88)
    注:*P < 0.05。
    下载: 导出CSV
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  • 收稿日期:  2020-12-29
  • 修回日期:  2021-01-28
  • 网络出版日期:  2021-09-24
  • 刊出日期:  2021-09-24

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