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7 岁儿童发育性协调障碍的决定因素:丹麦全国出生队列研究中的儿童。

Determinants of developmental coordination disorder in 7-year-old children: a study of children in the Danish National Birth Cohort.

机构信息

Department of Physiotherapy and Occupational Therapy, Roskilde/Koege Hospital, Roskilde, Denmark.

出版信息

Dev Med Child Neurol. 2013 Nov;55(11):1016-22. doi: 10.1111/dmcn.12223. Epub 2013 Aug 5.

Abstract

AIM

The aim of this study was to investigate early life determinants of developmental coordination disorder (DCD) in 7-year-old children.

METHOD

The study was based on data from 33,354 women and their children who participated in the 7-year follow-up study of the Danish National Birth Cohort. Information on several potential determinants (maternal age at conception, maternal occupational status, smoking and alcohol consumption during pregnancy, child's sex, intrauterine growth restriction, degree of preterm birth, and age at walking) was obtained from population registries, from interviews during pregnancy and when the child was 18 months old. The outcome in this study was DCD at 7 years of age, measured by the validated Developmental Coordination Disorder Questionnaire. The associations between the potential determinants and DCD were estimated using logistic regression.

RESULTS

The study population consisted of 17,065 males and 16,289 females (141 [0.4%] born very preterm [23(+0)-31(+6) wk]; 1281 [3.8%] born moderately preterm [32(+0)-36(+6) wk]; 29,044 [87.1%] were born term [37(+0)-41(+6) wk], and 2888 [8.7%] were born post-term [≥ 42(+0) wk]). Independently of each other, the following determinants were predictors of DCD: being a female (odds ratio [OR] 0.36 [95% confidence interval {CI} 0.31-0.41]); being born very preterm (OR 6.28 [95% CI 3.99-9.89]) or moderately preterm (OR 2.10 [95% CI 1.65-2.67]); being small for gestational age (OR 1.74 [95% CI 1.46-2.08]); being 15 months of age or more at walking attainment (OR 3.05 [95% CI 2.57-3.60]); and maternal occupational status (higher grade professionals (OR 1.28 [95% CI 1.02-1.61); economically inactive (OR 1.43 [95% CI 1.07-1.91]). Young maternal age and smoking were risk factors among term-born children.

INTERPRETATION

The risk of DCD increases with decreasing gestational age. Intrauterine growth restriction is also a strong risk factor, as well as delayed walking.

摘要

目的

本研究旨在探讨 7 岁儿童发育性协调障碍(DCD)的早期生活决定因素。

方法

该研究基于 33354 名女性及其子女的资料,这些女性参加了丹麦国家出生队列的 7 年随访研究。通过人口登记册、妊娠期间和儿童 18 个月时的访谈,获取了一些潜在决定因素(母亲受孕时的年龄、母亲的职业状况、妊娠期间吸烟和饮酒、儿童的性别、宫内生长受限、早产程度和行走年龄)的信息。本研究中,通过经过验证的发育协调障碍问卷测量,7 岁时的 DCD 为结局。使用逻辑回归估计潜在决定因素与 DCD 之间的关联。

结果

研究人群包括 17065 名男性和 16289 名女性(141 名[0.4%]极早产[23(+0)-31(+6)周];1281 名[3.8%]中度早产[32(+0)-36(+6)周];29044 名[87.1%]足月产[37(+0)-41(+6)周];2888 名[8.7%]过期产[≥42(+0)周])。独立于彼此,以下决定因素是 DCD 的预测因素:女性(优势比[OR]0.36[95%置信区间{CI}0.31-0.41]);极早产(OR 6.28[95% CI 3.99-9.89])或中度早产(OR 2.10[95% CI 1.65-2.67]);小于胎龄(OR 1.74[95% CI 1.46-2.08]);15 个月或以上开始行走(OR 3.05[95% CI 2.57-3.60]);母亲职业状况(高等级专业人员(OR 1.28[95% CI 1.02-1.61]);非经济活动(OR 1.43[95% CI 1.07-1.91])。年轻母亲年龄和吸烟是足月产儿童的危险因素。

解释

DCD 的风险随着胎龄的降低而增加。宫内生长受限也是一个强有力的危险因素,以及行走延迟。

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