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蒙古国幼儿发育迟缓风险的母亲社会人口学和心理预测因素

Maternal socio-demographic and psychological predictors for risk of developmental delays among young children in Mongolia.

作者信息

Dagvadorj Amarjargal, Ganbaatar Duurenbayar, O Balogun Olukunmi, Yonemoto Naohiro, Bavuusuren Bayasgalantai, Takehara Kenji, Mori Rintaro, Akahira-Azuma Moe

机构信息

Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.

出版信息

BMC Pediatr. 2018 Feb 19;18(1):68. doi: 10.1186/s12887-018-1017-y.

Abstract

BACKGROUND

Factors influencing child development are not well studied in developing settings, and especially in Mongolia. This cohort study examined the relationship between maternal socio-demographic and psychological conditions on risk of young child developmental delay.

METHODS

A total of 150 children aged between 13 ~ 24 months old participated in this study. The participants were randomly selected from a pre-existing cohort of 1297 children who were involved in a study on infant bilirubin nomogram development conducted at a tertiary health facility in Mongolia between 2012 and 2013. Child development was evaluated using the Mongolian Rapid Baby Scale (MORBAS), a validated scale for child development. The potential factors for child developmental delay were assessed using a pre-tested questionnaire comprising of 52 questions. Fisher's exact test and multivariable logistic regression analysis were conducted.

RESULTS

Seventeen (11%) out of the 150 children that participated in the study were at risk of developmental delay. There was a negative association between the risk of child developmental delay and higher maternal education (AOR 0.15, 95% CI: 0.03-0.66). Increasing maternal age (AOR 1.12, 95%CI: 0.98-1.27), maternal depression symptoms (AOR 4.93, 95%CI: 0.93-26.10), child gender being female (AOR 0.25, 95%CI: 0.06-1.00) and being from single mother household (AOR 0.14, 95%CI: 0.01-1.11) were also predictors for risk of developmental delay - although the association was marginal.

CONCLUSIONS

Our findings suggest that being of underprivileged social status, and poor psychological condition of mothers in Mongolia possibly increases the risk of child developmental delays. Interventions targeting these modifiable predictors are needed to develop prevention strategies for child developmental delay.

摘要

背景

在发展中地区,尤其是蒙古,影响儿童发育的因素尚未得到充分研究。这项队列研究调查了母亲的社会人口统计学和心理状况与幼儿发育迟缓风险之间的关系。

方法

共有150名年龄在13至24个月之间的儿童参与了本研究。参与者是从2012年至2013年在蒙古一家三级医疗机构进行的一项关于婴儿胆红素列线图发育研究的1297名儿童的现有队列中随机挑选出来的。使用蒙古快速婴儿量表(MORBAS)评估儿童发育情况,该量表是一种经过验证的儿童发育量表。使用一份经过预测试的包含52个问题的问卷评估儿童发育迟缓的潜在因素。进行了Fisher精确检验和多变量逻辑回归分析。

结果

参与研究的150名儿童中有17名(11%)存在发育迟缓风险。儿童发育迟缓风险与母亲受教育程度较高之间存在负相关(调整后比值比[AOR]为0.15,95%置信区间[CI]:0.03 - 0.66)。母亲年龄增加(AOR为1.12,95%CI:0.98 - 1.27)、母亲有抑郁症状(AOR为4.93,95%CI:0.93 - 26.10)、儿童性别为女性(AOR为0.25,95%CI:0.06 - 1.00)以及来自单亲家庭(AOR为0.14,95%CI:0.01 - 1.11)也是发育迟缓风险的预测因素——尽管这种关联很微弱。

结论

我们的研究结果表明,在蒙古,社会地位低下以及母亲心理状况不佳可能会增加儿童发育迟缓的风险。需要针对这些可改变的预测因素进行干预,以制定预防儿童发育迟缓的策略。

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