Bayrakli District Directorate of Health, 1606/1 Street, Apt. 10, Bayrakli, 35530, Izmir, Turkey.
Department of Family Medicine, Dokuz Eylul University School of Medicine, Inciralti, Izmir, Turkey.
Eur J Pediatr. 2018 May;177(5):691-697. doi: 10.1007/s00431-018-3109-y. Epub 2018 Feb 6.
Identifying children at risk for developmental delay (DD) is important for improving prognosis. In this sense, we estimated sociocultural factors that may be associated with DD in early childhood. In our nested case-control study, 95 were included in the case group and 190 were randomly selected to control group. To identify the risk factors, we conducted a backward conditional logistic regression and a final multivariable model was developed. Maternal age of ≥35 years, low maternal and paternal education level, low socioeconomic level, consanguineous marriage, and delivery by cesarean section increased the risk of DD. After adjustment, the risk of DD was significantly increased by maternal age ≥ 35 years (odds ratio (OR) 3.04, 95%CI 1.38-6.70), maternal education level of primary school or lower (OR 14.56, 95%CI 5.40-39.24), consanguineous marriage (OR 3.99, 95%CI 1.69-9.40), and delivery by cesarean section (OR 3.34, 95%CI 1.80-6.18).
DD can be identified early during well-child visits. In such cases, it is critical for the health of the child and community to screen for possible risk factors, eliminate the causes, and refer families to rehabilitation services. What is known: • The causes of DD may be classified into prenatal, perinatal, and postnatal factors. • Early identification may improve later outcomes of DD. Most studies conducted on this topic have focused on prematurity. What is new: • This study focused on maternal, paternal, and sociocultural factors that may be associated with DD in early childhood in this study that was conducted on a community-based sample. • The risk of DD was increased by maternal age ≥ 35 years, maternal education level of primary school or lower, consanguineous marriage and delivery by cesarean section.
识别发育迟缓（DD）风险儿童对于改善预后很重要。从这个意义上说，我们评估了可能与儿童早期 DD 相关的社会文化因素。在我们的嵌套病例对照研究中，95 例纳入病例组，190 例随机选择纳入对照组。为了确定危险因素，我们进行了向后条件逻辑回归，最后建立了多变量模型。母亲年龄≥35 岁、母亲和父亲教育水平低、社会经济水平低、近亲结婚和剖宫产分娩增加了 DD 的风险。调整后，母亲年龄≥35 岁（比值比（OR）3.04，95%置信区间（CI）1.38-6.70）、母亲教育水平为小学或以下（OR 14.56，95%CI 5.40-39.24）、近亲结婚（OR 3.99，95%CI 1.69-9.40）和剖宫产分娩（OR 3.34，95%CI 1.80-6.18）显著增加了 DD 的风险。
在儿童常规就诊时可以早期识别 DD。在这种情况下，为了孩子和社区的健康，筛查可能的危险因素、消除病因并将家庭转介至康复服务至关重要。已知情况：•DD 的病因可分为产前、围产期和产后因素。•早期识别可能改善 DD 的后期结果。大多数关于这个主题的研究都集中在早产上。新发现：•本研究关注的是可能与社区为基础的样本中儿童早期 DD 相关的母亲、父亲和社会文化因素。•DD 的风险增加与母亲年龄≥35 岁、母亲教育水平为小学或以下、近亲结婚和剖宫产分娩有关。
