孕次间隔与 5 岁儿童发育：一项基于人群数据的关联研究。
Interpregnancy intervals and child development at age 5: a population data linkage study.
机构信息
Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia.
出版信息
BMJ Open. 2021 Mar 23;11(3):e045319. doi: 10.1136/bmjopen-2020-045319.
OBJECTIVE
To investigate the associations between interpregnancy intervals (IPIs) and developmental vulnerability in children's first year of full-time school (age 5).
DESIGN
Retrospective cohort study using logistic regression. ORs were estimated for associations with IPIs with adjustment for child, parent and community sociodemographic variables.
SETTING
Western Australia (WA), 2002-2015.
PARTICIPANTS
34 574 WA born singletons with a 2009, 2012 or 2015 Australian Early Development Census (AEDC) record.
MAIN OUTCOME MEASURE
The AEDC measures child development across five domains; Physical Health and Wellbeing, Social Competence, Emotional Maturity, Language and Cognitive Skills (school-based) and Communication Skills and General Knowledge. Children with scores <10th percentile were classified as developmentally vulnerable on, one or more domains (DV1), or two or more domains (DV2).
RESULTS
22.8% and 11.5% of children were classified as DV1 and DV2, respectively. In the adjusted models (relative to the reference category, IPIs of 18-23 months), IPIs of <6 months were associated with an increased risk of children being classified as DV1 (adjusted OR (aOR) 1.17, 95% CI 1.08 to 1.34), DV2 (aOR 1.31, 95% CI 1.10 to 1.54) and an increased risk of developmental vulnerability for the domains of Physical Health and Wellbeing (aOR 1.25, 95% CI 1.06 to 1.48) and Emotional Maturity (aOR 1.36, 95% CI 1.12 to 1.66). All IPIs longer than the reference category were associated with and increased risk of children being classified as DV1 and DV2 (aOR >1.15). IPIs of 60-119 months and ≥120 months, were associated with an increased risk of developmental vulnerability on each of the five AEDC domains, with greater odds for each domain for the longer IPI category.
CONCLUSIONS
IPIs showed independent J-shaped relationships with developmental vulnerability, with short (<6 months) and longer (≥24 months) associated with increased risks of developmental vulnerability.
目的
探究生育间隔（interpregnancy intervals，IPI）与儿童入读全日制小学第一年（5 岁）期间发展脆弱性的关系。
设计
使用逻辑回归进行回顾性队列研究。通过调整儿童、父母和社区社会人口统计学变量，估计与 IPI 相关的比值比（odds ratio，OR）。
地点
澳大利亚西澳大利亚州，2002-2015 年。
参与者
34574 名在西澳大利亚州出生的单胎儿童，他们在 2009 年、2012 年或 2015 年有澳大利亚早期发展普查（Australian Early Development Census，AEDC）记录。
主要观察指标
AEDC 从五个领域衡量儿童的发展情况：身体健康和幸福感、社交能力、情绪成熟度、语言和认知技能（基于学校）以及沟通技能和一般知识。在一个或多个领域（DV1）或两个或更多领域（DV2）得分低于第 10 个百分位数的儿童被归类为发育脆弱。
结果
22.8%和 11.5%的儿童分别被归类为 DV1 和 DV2。在调整后的模型中（与参考类别 18-23 个月的 IPI 相比），6 个月以下的 IPI 与儿童被归类为 DV1（调整比值比[aOR]1.17，95%置信区间[CI]1.08 至 1.34）、DV2（aOR 1.31，95%CI 1.10 至 1.54）以及身体健康和幸福感（aOR 1.25，95%CI 1.06 至 1.48）和情绪成熟（aOR 1.36，95%CI 1.12 至 1.66）领域发育脆弱的风险增加有关。所有长于参考类别的 IPI 均与儿童被归类为 DV1 和 DV2 的风险增加有关（aOR>1.15）。60-119 个月和≥120 个月的 IPI 与每个 AEDC 领域的发育脆弱性呈独立的 J 形关系，较长的 IPI 类别与每个领域的较高风险相关。
结论
IPI 与发育脆弱性呈独立的 J 形关系，较短（<6 个月）和较长（≥24 个月）与发育脆弱性风险增加相关。
Zotero 插件