Bishai David, Trevitt Jamie L, Zhang Yiduo, McKenzie Lara B, Leventhal Tama, Gielen Andrea Carlson, Guyer Bernard
Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
Pediatrics. 2008 Nov;122(5):e980-7. doi: 10.1542/peds.2007-2995.
We sought to identify sociodemographic and familial correlates of injury in children aged 2 to 3 years.
The Healthy Steps data set describes 5565 infants who were enrolled at birth in 15 US cities in 1996-1997 and had follow-up until they were 30 to 33 months of age. Data were linked to medical claims reporting children's medically attended office visits by age 30 to 33 months. Each claim was accompanied by a reason for the visit. An analytical sample of 3449 was derived from the children who could be effectively followed up and linked to medical charts. Missing data were imputed by using multiple imputation with chained equations. The analytical sample showed no systematic evidence of sample selection bias. Multivariate logistic regression was used to determine the odds ratios of injury events.
Odds of medically attended injuries were decreased for children who received care from grandparents. Odds were increased for children who lived where fathers did not co-reside or in households where the parents never married. Statistical results were robust to the addition of a variety of covariates such as income, education, age, gender, and race.
Children are at higher risk for medically attended injury when their parents are unmarried. Having grandparents as caregivers seems to be protective. Household composition seems to play a key role in placing children at risk for medically attended injuries.
我们试图确定2至3岁儿童受伤的社会人口学和家庭相关因素。
“健康起步”数据集描述了1996 - 1997年在美国15个城市出生时登记入组且随访至30至33个月大的5565名婴儿。数据与报告儿童在30至33个月大时接受医疗门诊就诊情况的医疗理赔记录相关联。每份理赔记录都附有就诊原因。从能够有效随访并与病历关联的儿童中抽取了3449名作为分析样本。缺失数据通过使用链式方程多重填补法进行估算。分析样本未显示出样本选择偏倚的系统性证据。采用多变量逻辑回归来确定受伤事件的比值比。
由祖父母照顾的儿童发生需就医治疗损伤的几率降低。父亲不同住或父母从未结婚家庭中的儿童发生需就医治疗损伤的几率增加。在纳入各种协变量（如收入、教育程度、年龄、性别和种族）后，统计结果依然稳健。
父母未婚时，儿童需就医治疗损伤的风险更高。由祖父母作为照料者似乎具有保护作用。家庭构成似乎在儿童需就医治疗损伤的风险方面起着关键作用。
