西藏0~5岁藏族儿童心理行为发育与生长迟缓的关系

李剑波; 李亚杰; 尼玛曲措

doi:10.16835/j.cnki.1000-9817.2022.03.024

西藏0~5岁藏族儿童心理行为发育与生长迟缓的关系

doi: 10.16835/j.cnki.1000-9817.2022.03.024

1.
江苏省苏州市吴中区疾病预防控制中心行政办公室, 215104
2.
西藏自治区疾病预防控制中心

基金项目:

西藏自治区自然科学基金项目 XZ2019ZRG-142

西藏自治区自然科学基金项目 XZ202101ZR0103G

详细信息

作者简介:
李剑波(1996-), 男, 湖南常德人, 硕士, 主要研究方向为儿童和流动人口健康

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R844.1
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出版历程
- 收稿日期: 2021-10-18
- 修回日期: 2021-12-24
- 网络出版日期: 2022-03-29
- 刊出日期: 2022-03-25

Association of psychological and behavioral development with stunting of Tibetan children aged 0-5 years in Tibet

1.
Department of Administration Office, Center for Disease Control and Prevention of Wuzhong District, Suzhou (215104), Jiangsu Province, China

摘要

摘要: 目的了解西藏0~5岁藏族儿童心理行为发育现状, 为分析生长迟缓与儿童心理行为发育的关系提供基础数据。方法采用分层、与规模成比例的概率比例抽样方法和整群抽样方法, 于2020年9—11月间在西藏7个区县随机抽取2 788名0~71月龄藏族儿童进行问卷调查和体格检查。采用多因素Logistic回归模型分析生长迟缓对儿童心理行为发育的影响。结果西藏0~5岁藏族儿童心理行为发育偏异的检出率为24.68%, 其中言语、大运动、精细动作和社交4个能区发育偏异检出率分别为8.07%, 9.15%, 12.02%和12.73%。调整潜在混杂因素后, 生长迟缓儿童心理行为发育偏异风险的OR值(95%CI)为1.34(1.05~1.70), 其中与言语、精细动作和社交3个维度呈正关联。亚组分析显示, 生长迟缓与儿童心理行为发育的关联存在年龄(0~35月龄: OR=1.16, 95%CI=0.88~1.53;36~71月龄: OR=2.28, 95%CI=1.44~3.62)和性别差异(男童: OR=1.69, 95%CI=1.23~2.32;女童: OR=0.98, 95%CI=0.67~1.42)。结论西藏0~5岁藏族儿童心理行为发育偏异检出率较高, 生长迟缓与儿童心理行为发育偏异的风险相关。应以高年龄段男童为重点人群, 做好儿童营养和心理行为发育问题的早期筛查和综合干预工作。
- 精神卫生 /
- 行为 /
- 生长和发育 /
- 回归分析 /
- 儿童, 学龄前 /
- 少数民族
Abstract: Objective To understand the current situation of psychological and behavioral development of Tibetan children aged 0-5 years in Tibet, and to provide basic data for analyzing the relationship between stunning and children's psychological and behavioral development. Methods A total of 2 788 Tibetan children aged 0-71 months were randomly selected from seven districts and counties in Tibet from September to November 2020 by stratified PPS method and cluster sampling method for questionnaire survey and physical examination. Multivariate Logistic model was used to analyze the effect of stunting on psychological and behavioral development. Results The detection rate of psychological and behavioral development deviation of Tibetan children aged 0-5 years in Tibet was 24.68%, among which the detection rates of development deviation in language, gross motor skill, fine motor skill, and social-emotional were 8.07%, 9.15%, 12.02% and 12.73%, respectively. After adjusting for potential mixed factors, the OR value (95%CI) of the risk of psychological and behavioral development deviation of stunted children was 1.34(1.05-1.70). There was positive association with the three dimensions of language, fine motor skill, and social, respectively. Subgroup analysis showed significant differences in age (0-35 months old: OR=1.16, 95%CI=0.88-1.53; 36-71 months old: OR=2.28, 95%CI=1.44-3.62) and gender (boys: OR=1.69, 95%CI=1.23-2.32; girls: OR=0.98, 95%CI=0.67-1.42) in the association between stunting and psychological and behavioral development. Conclusion The detection rate of psychological and behavioral development deviation of 0-5-year-old Tibetan children is high. Stunting is associated with the risk of psychological and behavioral development. Early screening and comprehensive intervention of children's nutritional and neurodevelopmental should be carried out, especially among older age boys.
- Mental health /
- Behavior /
- Growth and development /
- Regression analysis /
- Child, preschool /
- Minority groups
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表 1 不同人口学特征藏族儿童心理行为发育偏异检出率比较

Table 1. Comparison of detection rates of psychological and behavioral developmental deviation among Tibetan children with different demographic characteristics

人口学指标	选项	人数	检出人数	χ²值	P值
性别	男	1 412	355(25.14)	0.33	0.56
	女	1 376	333(24.20)
月龄/月	0~11	447	230(51.45)	279.93	< 0.01
	12~23	556	148(26.62)
	24~35	378	107(28.31)
	36~47	346	77(22.25)
	48~59	572	89(15.56)
	60~71	489	37(7.57)
早产	是	140	36(25.71)	0.09	0.77
	否/不清楚	2 648	652(24.62)
低出生体重	是	172	60(34.88)	10.27	< 0.01
	否/不清楚	2 616	628(24.01)
睡眠时长	充足	1 832	409(22.33)	15.90	< 0.01
	不足	956	279(29.18)
家庭人均年收入/元	< 20 000	1 750	466(26.63)	20.52	< 0.01
	20 000~ < 60 000	654	162(24.77)
	≥60 000	384	60(15.63)
父亲文化程度^a	小学以下	1 347	345(25.61)	12.63	< 0.01
	小学	528	148(28.03)
	初中及以上	848	172(20.28)
母亲文化程度^b	小学以下	1 505	408(27.11)	20.82	< 0.01
	小学	529	140(26.47)
	初中及以上	740	137(18.51)
家庭饮用水	自来水/桶装水	2 003	464(23.17)	8.75	< 0.01
	井水/河水/湖水	785	224(28.54)
居住地海拔/m	< 3 500	1 308	352(26.91)	13.37	< 0.01
	3 500~4 499	504	94(18.65)
	≥4 500	976	242(24.80)
生长迟缓	是	449	159(35.41)	33.18	< 0.01
	否	2 339	529(22.62)
注： ( )内数字为检出率/%。a缺失值65个，b缺失值14个。

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表 2 西藏0~5岁藏族儿童生长迟缓与心理行为发育关联的Logistic回归分析[OR值(OR值95%CI),n=2788]

Table 2. Logistic regression analysis between stunting and psychological behavior development in Tibetan children aged 0-5 years[OR(OR 95%CI),n=2788]

模型	心理行为	言语	大运动	精细动作	社交
1	1.88(1.51~2.33)^**	1.79(1.29~2.47)^**	1.36(1.02~1.81)^*	2.05(1.52~2.76)^**	1.86(1.43~2.43)^**
2	1.38(1.10~1.75)^**	1.48(1.05~2.09)^*	1.28(0.94~1.74)	1.51(1.08~2.11)^*	1.55(1.16~2.07)^**
3	1.34(1.05~1.70)^*	1.44(1.01~2.05)^*	1.31(0.95~1.80)	1.50(1.06~2.12)^*	1.54(1.14~2.07)^**
注： *P < 0.01，P < 0.05。

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表 3 西藏0~5岁藏族儿童生长迟缓与心理行为发育关联的亚组分析结果

Table 3. Subgroup analysis results of the association between stunting and psychological behavior development in Tibetan children aged 0-5 years

亚组	选项	人数	OR值(OR值95%CI)	Z值	P值
月龄/月	< 36	1 359	1.16(0.88~1.53)	2.47	0.01
	≥36	1 356	2.28(1.44~3.62)
性别	男	1 379	1.69(1.23~2.32)	2.17	0.03
	女	1 336	0.98(0.67~1.42)
家庭人均年收入/元	< 20 000	1 689	1.40(1.05~1.87)	0.58	0.56
	≥20 000	1 026	1.20(0.77~1.86)
父亲文化程度	小学未毕业	1 342	1.28(0.93~1.76)	0.46	0.64
	小学及以上	1 373	1.43(0.99~2.07)
母亲文化程度	小学未毕业	1 470	1.31(0.97~1.77)	0.34	0.73
	小学及以上	1 245	1.43(0.96~2.12)
睡眠时长	充足	1 781	1.49(1.09~2.04)	0.99	0.32
	不足	934	1.16(0.80~1.69)
居住地海拔/m	＜3 500	1 284	1.38(0.93~2.05)	0.00	1.00
	≥3 500	1 431	1.38(1.02~1.88)
注：调整月龄、性别、早产、低出生体重、睡眠时长、居住地海拔、父母亲文化程度、家庭年收入和家庭饮用水。

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