Ryckman Kandace, Richmond Sarah A, Anderson Laura N, Birken Catherine S, Parkin Patricia C, Macarthur Colin, Maguire Jonathon L, Howard Andrew W
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario.
Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario.
Paediatr Child Health. 2017 Jul;22(4):195-198. doi: 10.1093/pch/pxx049. Epub 2017 May 5.
Approximately one-half of all children will sustain a fracture before adulthood. Understanding the factors that place a child at increased risk of fracture is necessary to inform effective injury prevention strategies. The purpose of this study was to examine the association between temperament and fracture risk in preschool-aged children.
Children aged 3 to 6 years who were diagnosed with a fracture were recruited from the Hospital for Sick Children Fracture Clinic. Using a retrospective case-control study design, the 148 cases were frequency-matched by age and sex to 426 controls from the TARGet Kids primary care paediatric cohort. The Childhood Behaviour Questionnaire, a 36-item caregiver response questionnaire was used to assess three of the following temperament factors: surgency (e.g., high activity level), negative affect (e.g., anger, fear, discomfort) and effortful control (e.g., attentional focusing).
Unadjusted logistic models demonstrated no association between children with previous fracture and higher scores of surgency (unadjusted odds ratio [OR]=1.06, 95% confidence interval [CI]: 0.84, 1.34), negative affect (unadjusted OR=1.15, 95% CI: 0.93, 1.42) or effortful control (unadjusted OR=0.80, 95% CI: 0.63, 1.03). Further, models adjusted for covariates also demonstrated no significant association with surgency (1.00, 95% CI: 0.78, 1.29), negative affect (1.09, 95% CI: 0.86, 1.37) and effortful control (0.80, 95% CI: 0.61, 1.05).
None of the three main temperament types identified by the Childhood Behaviour Questionnaire were associated with an increase in fracture risk.
约一半儿童在成年前会发生骨折。了解使儿童骨折风险增加的因素对于制定有效的伤害预防策略至关重要。本研究的目的是探讨学龄前儿童的气质与骨折风险之间的关联。
从病童医院骨折诊所招募3至6岁被诊断为骨折的儿童。采用回顾性病例对照研究设计，将148例病例按年龄和性别与来自TARGet Kids初级保健儿科队列的426名对照进行频率匹配。使用《儿童行为问卷》（一份由照料者回答的36项问卷）来评估以下三种气质因素：外向性（如高活动水平）、消极情绪（如愤怒、恐惧、不适）和努力控制（如注意力集中）。
未调整的逻辑模型显示，既往有骨折的儿童与较高的外向性得分（未调整比值比[OR]=1.06，95%置信区间[CI]：0.84，1.34）、消极情绪得分（未调整OR=1.15，95%CI：0.93，1.42）或努力控制得分（未调整OR=0.80，95%CI：0.63，1.03）之间无关联。此外，对协变量进行调整后的模型也显示与外向性（1.00，95%CI：0.78，1.29）、消极情绪（1.09，95%CI：0.86，1.37）和努力控制（0.80，95%CI：0.61，1.05）均无显著关联。
《儿童行为问卷》确定的三种主要气质类型均与骨折风险增加无关。
