年龄与发育进程问卷(中文版)评估上海市3～66月龄儿童神经精神发育春夏秋季的差异

摘要

目的 应用"年龄与发育进程问卷:父母完成的儿童发育监测系统"的标准化翻译中文版(ASQ-C),研究上海市3～66月龄儿童在春、夏和秋季神经精神发育的差异.方法 于春、夏和秋季,在上海市3～66月龄儿童中分层随机整群抽样.共有8 472名儿童的父母和(或)养育人完成了儿童月龄相应的ASQ-C测试.儿童ASQ-C的量表总分及沟通(CM)、大运动(GM)、精细运动(FM)、解决问题(CG)和个人-社会(PS)能区得分以±s表示;多组样本均数的比较采用完全随机设计的单因素方差分析;两两比较采用SNK法.采用多元线性回归分析以排除混杂因素.结果 ①不同季节测试儿童的ASQ-C量表总分间差异有统计学意义(P＜0.01),从高至低的排序是秋、夏和春季,秋季显著高于夏和春季(P＜0.05),夏季与春季间差异无统计学意义;②不同季节测试儿童的ASQ-C 5个能区得分间差异均有统计学意义(P＜0.01或＜0.05),均以秋季最高;其中CM能区得分从高至低的排序为秋、春和夏季,其他4个能区得分从高至低的排序均为秋、夏和春季.两两比较结果显示,CM能区得分秋季显著高于夏季(P＜0.05),秋季与春季、春季与夏季间差异无统计学意义;其他4个能区得分均表现为秋季显著高于夏和春季(P＜0.05).结论 季节对3～66月龄儿童的神经精神发育有影响;进一步研究季节或气候与儿童发育的关系很有必要;在儿童发育评估量表的研究中,建议考虑季节因素的影响.%Objective To investigate the influences of the three seasons ( I. E. , spring, summer and autumn ) on the neuropsychological development of children aged 3-66 months living in Shanghai, using the developmental screening scales, the standard Chinese translated Ages & Stages Questionnaires( ASQ-C ): A Parent-Completed Child Monitoring System. Methods During the three seasons, using a stratified clustering, random sampling method, children aged 3-66 months were recruited. Parents/caregivers of a total of 8 472 children completed age-appropriate ASQ-C. The statistical software of SPSS 13.0 was used for data analysis. Means and standard deviations of the children's ASQ-C total and domain scores including communication( CM ), gross motion( GM ), fine motion( FM ), problem solving( CG ), and personal-social ( PS ), by seasons were calculated. One-way ANOVA was chosen for multiple comparisons of sample means. The SNK method was used for pairwise comparison and a differencewas deemed statistically significant when P <0. 05. Multiple linear regression was used to control for confounders. Results The children's total ASQ-C scores varied significantly by season ( P <0. 01 ) in the sequence of autumn, summer and spring. The pairwise comparison showed that the children had higher ASQ scores in autumn than in both summer and spring ( P <0. 05 ) with non-significant difference between the scores in summer and spring. The total scores in each of the five developmental areas also varied significantly by season ( P <0. 01 or 0. 05 ). Scores were the highest in autumn for all areas. For the CM area, children' scores were the highest in autumn, followed by spring and summer, while for the other four developmental areas, the sequence of seasons was autumn, summer and spring. The pairwise comparisons showed that children in autumn had much higher CM scores than in summer with no significant difference in CM scores between summer and spring, or between spring and summer. While for all the other four areas (I.e., GM, FM, CG and PS ), scores in autumn were higher than in summer and spring( P < 0. 05 ). Moreover, GM scores in summer were much higher than those in spring ( P <0.05 ). Conclusions Seasons had an influence on the assessment on young children's development. Reasonable design for further studies on the relations between seasons or climate and the development of children is needed. It is suggested that seasonal influence should be considered when children' s developmental scale is researched.