Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
Department of Environmental Health Sciences, University at Albany School of Public Health, Albany, NY.
J Pediatr. 2022 Mar;242:184-191.e5. doi: 10.1016/j.jpeds.2021.11.010. Epub 2021 Nov 11.
To determine whether feeding problems are indicators of developmental delay.
In this prospective longitudinal cohort study, mothers of 3597 children (49% female, 35% multiples) reported on their children's feeding problems and developmental delays (using the Ages and Stages Questionnaire [ASQ]) when children were age 18, 24, and 30 months. Average scores of feeding problems were computed at each age, as well as a categorical score indicating a persistently high number of feeding problems ≥90th percentile across time. The Battelle Developmental Inventory, Second Edition (BDI-2) was used to assess development in 5 domains for a subset of children at 4 years.
In adjusted analyses, feeding problems (per point increase) were increasingly associated with 6 ASQ domains from 18 months (OR, 1.30-1.98) to 24 months (OR, 2.07-2.69) to 30 months (OR, 3.90-5.64). Compared with children who never experienced feeding problems, children who experienced a high number of feeding problems at 1 or 2 time points were more than twice as likely to have a delay on all ASQ domains (OR, 2.10-2.50), and children who experienced a high number of feeding problems at all 3 time points were ≥4-fold more likely to have a delay on all ASQ domains (OR, 3.94-5.05). Children with 1-point higher feeding problems at 30 months scored 3-4 points lower in all BDI-2 domains at 4 years.
Frequent feeding problems, especially those that persist into the third year, could be used to identify children at risk for developmental delay for more targeted screening.
确定喂养问题是否是发育迟缓的指标。
在这项前瞻性纵向队列研究中，3597 名儿童的母亲（49%为女性，35%为双胞胎）报告了他们的孩子在 18、24 和 30 个月时的喂养问题和发育迟缓（使用年龄和阶段问卷 [ASQ]）。在每个年龄计算喂养问题的平均分数，并计算一个分类分数，表示在整个时间内持续存在大量喂养问题（≥第 90 百分位数）。对于一小部分儿童，在 4 岁时使用第二代贝利发育量表（BDI-2）评估 5 个领域的发育情况。
在调整后的分析中，从 18 个月（OR，1.30-1.98）到 24 个月（OR，2.07-2.69）到 30 个月（OR，3.90-5.64），喂养问题（每增加一个点）与 6 个 ASQ 领域越来越相关。与从未经历过喂养问题的儿童相比，在 1 个或 2 个时间点经历过大量喂养问题的儿童在所有 ASQ 领域出现延迟的可能性是两倍多（OR，2.10-2.50），在所有 3 个时间点经历过大量喂养问题的儿童在所有 ASQ 领域出现延迟的可能性是≥4 倍（OR，3.94-5.05）。在 30 个月时，喂养问题增加 1 分的儿童在 4 岁时在所有 BDI-2 领域的得分低 3-4 分。
频繁的喂养问题，尤其是持续到第三年的喂养问题，可用于识别有发育迟缓风险的儿童，以便进行更有针对性的筛查。
