家庭养育照护环境与孤独症/高危儿童的相关性研究

A study on the correlation between family nurturing care environment and autism/high-risk children

  • 摘要: 【目的】 分析家庭养育照护环境与孤独症谱系障碍(ASD)/高危儿童的相关性,为ASD/高危的三级预防提供科学依据。【方法】 采用病例对照研究,选取30例ASD/高危儿童为病例组,对照组为同期于辖区社区卫生服务中心和区妇幼保健院常规体检的113例正常儿童。通过儿童保健系统及自制问卷调查获取母亲孕产信息及儿童信息、家庭养育照护信息。应用多因素logistic回归分析研究儿童发生ASD/高危的相关因素。【结果】 多因素logistic回归分析显示,在孕产和儿童因素中,母亲妊娠前3个月及妊娠期有不良情况(OR=6.03,95% CI: 1.575~23.062)、男童(OR=4.06,95% CI: 1.046~15.784)与儿童发生ASD/高危呈正相关(P<0.05),在家庭养育照护因素中,饮食结构不均衡(OR=7.28,95% CI: 1.819~29.148)与儿童发生ASD/高危呈正相关(P<0.05),父亲陪伴(OR=0.03,95% CI: 0.001~0.426)、亲子互动及回应性照护(OR=0.82,95% CI: 0.704~0.963)与儿童发生ASD/高危呈负相关(P<0.05)【结论】 与儿童发生ASD/高危正相关的因素有母亲孕前3个月及孕期有不良情况、男童、饮食结构不均衡,负相关的因素有父亲陪伴、亲子互动及回应性照护。临床上应综合把控母亲孕前孕期健康、儿童饮食及家庭养育照护,重点关注男童发育监测,早发现、早诊断、早干预。

     

    Abstract: Objective To analyze the correlation between family nurturing care environment and autism spectrum disorders (ASD)/high-risk children, in order to provide scientific evidences for the tertiary prevention of ASD/highrisk children. Methods A case-control study was conducted, enrolling 30 children with ASD/high-risk as the case group and 113 normal children who underwent routine physical examinations at the community health service centers and district maternal and child health care hospital during the same period as the control group. Maternal prenatal and perinatal information, children's information, and family nurturing care information were collected through the child healthcare system and a self-designed questionnaire. Multivariate logistic regression analyses were used to identify the relevant factors for ASD/high-risk occurrence in children. Results Multivariate logistic regression analyses showed that among maternal and child factors, maternal adverse conditions during the 3 months before pregnancy and throughout pregnancy (OR=6.03, 95%CI: 1.575-23.062), and male gender (OR=4.06, 95%CI: 1.046-15.784) were positively correlated with ASD/high-risk occurrence in children (P<0.05). Among family nurturing care factors, unbalanced dietary structure (OR=7.28, 95%CI: 1.819-29.148) was positively correlated with ASD/high-risk occurrence in children (P<0.05), while paternal companionship (OR=0.03, 95%CI: 0.001-0.426) and parent-child interaction with responsive care (OR=0.82, 95%CI: 0.704-0.963) were negatively correlated with ASD/high-risk occurrence in children (P<0.05). Conclusion Factors positively correlated with ASD/high-risk occurrence in children included maternal adverse conditions during the 3 months before pregnancy and throughout pregnancy, male gender, and unbalanced dietary structure. Factors negatively correlated with it included paternal companionship and parent-child interaction with responsive care. Clinically, we should comprehensively manage maternal pre-pregnancy and prenatal health, children's diet and family nurturing care, focus on developmental monitoring of boys, and achieve early detection, early diagnosis and early intervention.

     

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